National Provider Identifier [NPI]: |
1033178090 |
Last Name Of The Provider |
CESSNA |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8TH AVENUE & C STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841430001 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
809 |
Number Of Medicare Beneficiaries |
173 |
Total Submitted Charge Amount |
127884 |
Total Medicare Allowed Amount |
32552.38 |
Total Medicare Payment Amount |
25164.5 |
Total Medicare Standardized Payment Amount |
22339.62 |
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 |
18 |
Number Of Medical Services |
809 |
Number Of Medicare Beneficiaries With Medical Services |
173 |
Total Medical Submitted Charge Amount |
127884 |
Total Medical Medicare Allowed Amount |
32552.38 |
Total Medical Medicare Payment Amount |
25164.5 |
Total Medical Medicare Standardized Payment Amount |
22339.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
155 |
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 |
151 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.8509 |