National Provider Identifier [NPI]: |
1023338076 |
Last Name Of The Provider |
BOYETTE |
First Name Of The Provider |
CHERYL |
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 |
2727 W DR MARTIN LUTHER KING JR BLVD |
Street Address 2 Of The Provider |
STE 310 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336076383 |
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 |
28 |
Number Of Services |
70 |
Number Of Medicare Beneficiaries |
69 |
Total Submitted Charge Amount |
99306 |
Total Medicare Allowed Amount |
8251.32 |
Total Medicare Payment Amount |
6427.98 |
Total Medicare Standardized Payment Amount |
6239.75 |
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 |
28 |
Number Of Medical Services |
70 |
Number Of Medicare Beneficiaries With Medical Services |
69 |
Total Medical Submitted Charge Amount |
99306 |
Total Medical Medicare Allowed Amount |
8251.32 |
Total Medical Medicare Payment Amount |
6427.98 |
Total Medical Medicare Standardized Payment Amount |
6239.75 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
34 |
Number Of Male Beneficiaries |
35 |
Number Of Non Hispanic White Beneficiaries |
45 |
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 |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3956 |