National Provider Identifier [NPI]: |
1073563409 |
Last Name Of The Provider |
STEVENS |
First Name Of The Provider |
BRENDA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 ELLIOT WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANCHESTER |
Zip Code Of The Provider |
031033502 |
State Code Of The Provider |
NH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
243 |
Number Of Medicare Beneficiaries |
233 |
Total Submitted Charge Amount |
215306 |
Total Medicare Allowed Amount |
23489.31 |
Total Medicare Payment Amount |
18038.29 |
Total Medicare Standardized Payment Amount |
18189.23 |
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 |
41 |
Number Of Medical Services |
243 |
Number Of Medicare Beneficiaries With Medical Services |
233 |
Total Medical Submitted Charge Amount |
215306 |
Total Medical Medicare Allowed Amount |
23489.31 |
Total Medical Medicare Payment Amount |
18038.29 |
Total Medical Medicare Standardized Payment Amount |
18189.23 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
207 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
189 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1534 |