National Provider Identifier [NPI]: |
1326024282 |
Last Name Of The Provider |
MISTLER |
First Name Of The Provider |
DEBRA |
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 |
1272 GARRISON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
371292598 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
480 |
Number Of Medicare Beneficiaries |
473 |
Total Submitted Charge Amount |
453000 |
Total Medicare Allowed Amount |
70247.83 |
Total Medicare Payment Amount |
54668.56 |
Total Medicare Standardized Payment Amount |
57877.87 |
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 |
13 |
Number Of Medical Services |
480 |
Number Of Medicare Beneficiaries With Medical Services |
473 |
Total Medical Submitted Charge Amount |
453000 |
Total Medical Medicare Allowed Amount |
70247.83 |
Total Medical Medicare Payment Amount |
54668.56 |
Total Medical Medicare Standardized Payment Amount |
57877.87 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
265 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
301 |
Number Of Male Beneficiaries |
172 |
Number Of Non Hispanic White Beneficiaries |
440 |
Number Of Black or African American Beneficiaries |
13 |
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 |
402 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0509 |