National Provider Identifier [NPI]: |
1336447937 |
Last Name Of The Provider |
URICH |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 ELECTRIC RD |
Street Address 2 Of The Provider |
ANESTHESIA DEPARTMENT |
City Of The Provider |
SALEM |
Zip Code Of The Provider |
241537474 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
282 |
Number Of Medicare Beneficiaries |
280 |
Total Submitted Charge Amount |
284313.1 |
Total Medicare Allowed Amount |
39753.04 |
Total Medicare Payment Amount |
30977.67 |
Total Medicare Standardized Payment Amount |
31650.14 |
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 |
59 |
Number Of Medical Services |
282 |
Number Of Medicare Beneficiaries With Medical Services |
280 |
Total Medical Submitted Charge Amount |
284313.1 |
Total Medical Medicare Allowed Amount |
39753.04 |
Total Medical Medicare Payment Amount |
30977.67 |
Total Medical Medicare Standardized Payment Amount |
31650.14 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
108 |
Number Of Non Hispanic White Beneficiaries |
255 |
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 |
243 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.2739 |