National Provider Identifier [NPI]: |
1134167133 |
Last Name Of The Provider |
SYMRENG |
First Name Of The Provider |
TOMMY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3700 WASHINGTON AVE |
Street Address 2 Of The Provider |
ST MARYS MEDICAL CENTER ANESTHESIA DEPT |
City Of The Provider |
EVANSVILLE |
Zip Code Of The Provider |
47750 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
636 |
Number Of Medicare Beneficiaries |
426 |
Total Submitted Charge Amount |
414252 |
Total Medicare Allowed Amount |
93849.63 |
Total Medicare Payment Amount |
73183.62 |
Total Medicare Standardized Payment Amount |
76319.98 |
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 |
75 |
Number Of Medical Services |
636 |
Number Of Medicare Beneficiaries With Medical Services |
426 |
Total Medical Submitted Charge Amount |
414252 |
Total Medical Medicare Allowed Amount |
93849.63 |
Total Medical Medicare Payment Amount |
73183.62 |
Total Medical Medicare Standardized Payment Amount |
76319.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
261 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
400 |
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 |
351 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4832 |