National Provider Identifier [NPI]: |
1033117114 |
Last Name Of The Provider |
ROBINSON |
First Name Of The Provider |
CLYN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1050 E SOUTH TEMPLE |
Street Address 2 Of The Provider |
DEPARTMENT OF ANESTHESIA |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841021507 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
243 |
Number Of Medicare Beneficiaries |
183 |
Total Submitted Charge Amount |
275356 |
Total Medicare Allowed Amount |
67245.67 |
Total Medicare Payment Amount |
51816.22 |
Total Medicare Standardized Payment Amount |
52140.27 |
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 |
54 |
Number Of Medical Services |
243 |
Number Of Medicare Beneficiaries With Medical Services |
183 |
Total Medical Submitted Charge Amount |
275356 |
Total Medical Medicare Allowed Amount |
67245.67 |
Total Medical Medicare Payment Amount |
51816.22 |
Total Medical Medicare Standardized Payment Amount |
52140.27 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
168 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1575 |