National Provider Identifier [NPI]: |
1447368204 |
Last Name Of The Provider |
ALBRITTON |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MSN-CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 FORT LOUDOUN MEDICAL CENTER DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LENOIR CITY |
Zip Code Of The Provider |
377725673 |
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 |
40 |
Number Of Services |
229 |
Number Of Medicare Beneficiaries |
212 |
Total Submitted Charge Amount |
188480 |
Total Medicare Allowed Amount |
25625.11 |
Total Medicare Payment Amount |
19979.06 |
Total Medicare Standardized Payment Amount |
20552.77 |
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 |
40 |
Number Of Medical Services |
229 |
Number Of Medicare Beneficiaries With Medical Services |
212 |
Total Medical Submitted Charge Amount |
188480 |
Total Medical Medicare Allowed Amount |
25625.11 |
Total Medical Medicare Payment Amount |
19979.06 |
Total Medical Medicare Standardized Payment Amount |
20552.77 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
133 |
Number Of Black or African American Beneficiaries |
43 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1467 |