National Provider Identifier [NPI]: |
1588627491 |
Last Name Of The Provider |
ELLINGTON |
First Name Of The Provider |
GAYRON |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 20TH ST |
Street Address 2 Of The Provider |
SUITE 606 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379161809 |
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 |
44 |
Number Of Services |
143 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
250509 |
Total Medicare Allowed Amount |
38133.51 |
Total Medicare Payment Amount |
28654.17 |
Total Medicare Standardized Payment Amount |
31865.89 |
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 |
44 |
Number Of Medical Services |
143 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
250509 |
Total Medical Medicare Allowed Amount |
38133.51 |
Total Medical Medicare Payment Amount |
28654.17 |
Total Medical Medicare Standardized Payment Amount |
31865.89 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2185 |