National Provider Identifier [NPI]: |
1699012179 |
Last Name Of The Provider |
CROOK |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6839 S CANTON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741363402 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
141 |
Number Of Medicare Beneficiaries |
140 |
Total Submitted Charge Amount |
137100 |
Total Medicare Allowed Amount |
30206.01 |
Total Medicare Payment Amount |
22750.7 |
Total Medicare Standardized Payment Amount |
23918.3 |
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 |
48 |
Number Of Medical Services |
141 |
Number Of Medicare Beneficiaries With Medical Services |
140 |
Total Medical Submitted Charge Amount |
137100 |
Total Medical Medicare Allowed Amount |
30206.01 |
Total Medical Medicare Payment Amount |
22750.7 |
Total Medical Medicare Standardized Payment Amount |
23918.3 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
121 |
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 |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1631 |