National Provider Identifier [NPI]: |
1831156884 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30200 TELEGRAPH RD |
Street Address 2 Of The Provider |
SUITE 220 |
City Of The Provider |
BINGHAM FARMS |
Zip Code Of The Provider |
480254502 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
163 |
Number Of Medicare Beneficiaries |
159 |
Total Submitted Charge Amount |
149005 |
Total Medicare Allowed Amount |
15357.49 |
Total Medicare Payment Amount |
11031.27 |
Total Medicare Standardized Payment Amount |
10419.71 |
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 |
19 |
Number Of Medical Services |
163 |
Number Of Medicare Beneficiaries With Medical Services |
159 |
Total Medical Submitted Charge Amount |
149005 |
Total Medical Medicare Allowed Amount |
15357.49 |
Total Medical Medicare Payment Amount |
11031.27 |
Total Medical Medicare Standardized Payment Amount |
10419.71 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
108 |
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 |
116 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4767 |