National Provider Identifier [NPI]: |
1952631806 |
Last Name Of The Provider |
VINCENT |
First Name Of The Provider |
JOSHUA |
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 |
30 S CAYUGA RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WILLIAMSVILLE |
Zip Code Of The Provider |
142216728 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
116 |
Number Of Medicare Beneficiaries |
114 |
Total Submitted Charge Amount |
188667.9 |
Total Medicare Allowed Amount |
21852.45 |
Total Medicare Payment Amount |
16815.06 |
Total Medicare Standardized Payment Amount |
16919.03 |
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 |
42 |
Number Of Medical Services |
116 |
Number Of Medicare Beneficiaries With Medical Services |
114 |
Total Medical Submitted Charge Amount |
188667.9 |
Total Medical Medicare Allowed Amount |
21852.45 |
Total Medical Medicare Payment Amount |
16815.06 |
Total Medical Medicare Standardized Payment Amount |
16919.03 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
75 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
|
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4661 |