National Provider Identifier [NPI]: |
1215277579 |
Last Name Of The Provider |
HERRERA |
First Name Of The Provider |
GELIZA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9000 FRANKLIN SQUARE DR |
Street Address 2 Of The Provider |
DEPT. OF ANESTHESIOLOGY, 2 NORTH |
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212373901 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
211 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
181740 |
Total Medicare Allowed Amount |
47724.59 |
Total Medicare Payment Amount |
37300.83 |
Total Medicare Standardized Payment Amount |
35501.69 |
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 |
52 |
Number Of Medical Services |
211 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
181740 |
Total Medical Medicare Allowed Amount |
47724.59 |
Total Medical Medicare Payment Amount |
37300.83 |
Total Medical Medicare Standardized Payment Amount |
35501.69 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
171 |
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 |
148 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9403 |