National Provider Identifier [NPI]: |
1285939124 |
Last Name Of The Provider |
MORRIS |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9601 I-630 |
Street Address 2 Of The Provider |
EXIT 7 |
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722057202 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
581 |
Number Of Medicare Beneficiaries |
528 |
Total Submitted Charge Amount |
524497 |
Total Medicare Allowed Amount |
74841.96 |
Total Medicare Payment Amount |
57557.12 |
Total Medicare Standardized Payment Amount |
61865.69 |
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 |
20 |
Number Of Medical Services |
581 |
Number Of Medicare Beneficiaries With Medical Services |
528 |
Total Medical Submitted Charge Amount |
524497 |
Total Medical Medicare Allowed Amount |
74841.96 |
Total Medical Medicare Payment Amount |
57557.12 |
Total Medical Medicare Standardized Payment Amount |
61865.69 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
151 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
343 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
278 |
Number Of Black or African American Beneficiaries |
239 |
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 |
177 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3491 |