National Provider Identifier [NPI]: |
1710091343 |
Last Name Of The Provider |
ALEXANDER |
First Name Of The Provider |
COLBY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6916 S FOREST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GILBERT |
Zip Code Of The Provider |
852989170 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
188 |
Number Of Medicare Beneficiaries |
146 |
Total Submitted Charge Amount |
186825 |
Total Medicare Allowed Amount |
40823.84 |
Total Medicare Payment Amount |
31733.84 |
Total Medicare Standardized Payment Amount |
32307.39 |
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 |
45 |
Number Of Medical Services |
188 |
Number Of Medicare Beneficiaries With Medical Services |
146 |
Total Medical Submitted Charge Amount |
186825 |
Total Medical Medicare Allowed Amount |
40823.84 |
Total Medical Medicare Payment Amount |
31733.84 |
Total Medical Medicare Standardized Payment Amount |
32307.39 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
111 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3142 |