National Provider Identifier [NPI]: |
1336561653 |
Last Name Of The Provider |
COLLIER |
First Name Of The Provider |
KATHERINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9500 EUCLID AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
441950001 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
123 |
Number Of Medicare Beneficiaries |
122 |
Total Submitted Charge Amount |
74991.87 |
Total Medicare Allowed Amount |
17494.54 |
Total Medicare Payment Amount |
13715.66 |
Total Medicare Standardized Payment Amount |
13743.6 |
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 |
51 |
Number Of Medical Services |
123 |
Number Of Medicare Beneficiaries With Medical Services |
122 |
Total Medical Submitted Charge Amount |
74991.87 |
Total Medical Medicare Allowed Amount |
17494.54 |
Total Medical Medicare Payment Amount |
13715.66 |
Total Medical Medicare Standardized Payment Amount |
13743.6 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
55 |
Number Of Male Beneficiaries |
67 |
Number Of Non Hispanic White Beneficiaries |
99 |
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
16 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9271 |