National Provider Identifier [NPI]: |
1558361410 |
Last Name Of The Provider |
DAVIS |
First Name Of The Provider |
BEDFORD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
110 29TH AVE N |
Street Address 2 Of The Provider |
STE 202 |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372031401 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
172 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
136152.3 |
Total Medicare Allowed Amount |
19664.66 |
Total Medicare Payment Amount |
15356.48 |
Total Medicare Standardized Payment Amount |
16368.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
172 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
136152.3 |
Total Medical Medicare Allowed Amount |
19664.66 |
Total Medical Medicare Payment Amount |
15356.48 |
Total Medical Medicare Standardized Payment Amount |
16368.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
157 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4697 |