National Provider Identifier [NPI]: |
1801887740 |
Last Name Of The Provider |
BECK |
First Name Of The Provider |
BERNARD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 S GRANT AVE |
Street Address 2 Of The Provider |
3RD FL |
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
432154701 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
181 |
Number Of Medicare Beneficiaries |
180 |
Total Submitted Charge Amount |
148686.4 |
Total Medicare Allowed Amount |
25163.74 |
Total Medicare Payment Amount |
19309.93 |
Total Medicare Standardized Payment Amount |
19454.3 |
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 |
35 |
Number Of Medical Services |
181 |
Number Of Medicare Beneficiaries With Medical Services |
180 |
Total Medical Submitted Charge Amount |
148686.4 |
Total Medical Medicare Allowed Amount |
25163.74 |
Total Medical Medicare Payment Amount |
19309.93 |
Total Medical Medicare Standardized Payment Amount |
19454.3 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
104 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
147 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4142 |