National Provider Identifier [NPI]: |
1336162478 |
Last Name Of The Provider |
ROJO |
First Name Of The Provider |
JANET |
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 |
3990 JOHN R ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482012018 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
217 |
Number Of Medicare Beneficiaries |
213 |
Total Submitted Charge Amount |
216095 |
Total Medicare Allowed Amount |
31201.43 |
Total Medicare Payment Amount |
24064.81 |
Total Medicare Standardized Payment Amount |
22922.6 |
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 |
55 |
Number Of Medical Services |
217 |
Number Of Medicare Beneficiaries With Medical Services |
213 |
Total Medical Submitted Charge Amount |
216095 |
Total Medical Medicare Allowed Amount |
31201.43 |
Total Medical Medicare Payment Amount |
24064.81 |
Total Medical Medicare Standardized Payment Amount |
22922.6 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
115 |
Number Of Male Beneficiaries |
98 |
Number Of Non Hispanic White Beneficiaries |
104 |
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 |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.7789 |