National Provider Identifier [NPI]: |
1619073921 |
Last Name Of The Provider |
HORKINS |
First Name Of The Provider |
MARCIE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2 COLUMBIA DR |
Street Address 2 Of The Provider |
SUITE A 327 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336063508 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
389 |
Number Of Medicare Beneficiaries |
364 |
Total Submitted Charge Amount |
211610 |
Total Medicare Allowed Amount |
44600.38 |
Total Medicare Payment Amount |
34747.29 |
Total Medicare Standardized Payment Amount |
32997.7 |
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 |
49 |
Number Of Medical Services |
389 |
Number Of Medicare Beneficiaries With Medical Services |
364 |
Total Medical Submitted Charge Amount |
211610 |
Total Medical Medicare Allowed Amount |
44600.38 |
Total Medical Medicare Payment Amount |
34747.29 |
Total Medical Medicare Standardized Payment Amount |
32997.7 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
327 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
304 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3069 |