National Provider Identifier [NPI]: |
1811934367 |
Last Name Of The Provider |
PONIGAR |
First Name Of The Provider |
CARRI |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
C.R.N.A. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12511 WORLD PLAZA LN |
Street Address 2 Of The Provider |
BUILDING 50 |
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339073991 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
121 |
Number Of Medicare Beneficiaries |
118 |
Total Submitted Charge Amount |
95830.6 |
Total Medicare Allowed Amount |
25084.31 |
Total Medicare Payment Amount |
18951.87 |
Total Medicare Standardized Payment Amount |
18993.13 |
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 |
40 |
Number Of Medical Services |
121 |
Number Of Medicare Beneficiaries With Medical Services |
118 |
Total Medical Submitted Charge Amount |
95830.6 |
Total Medical Medicare Allowed Amount |
25084.31 |
Total Medical Medicare Payment Amount |
18951.87 |
Total Medical Medicare Standardized Payment Amount |
18993.13 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
67 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
105 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9935 |