National Provider Identifier [NPI]: |
1114987369 |
Last Name Of The Provider |
CARROLL |
First Name Of The Provider |
MARGARET |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1343 N FOUNTAIN BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
455041422 |
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 |
27 |
Number Of Services |
116 |
Number Of Medicare Beneficiaries |
115 |
Total Submitted Charge Amount |
108192 |
Total Medicare Allowed Amount |
20541.37 |
Total Medicare Payment Amount |
15954.4 |
Total Medicare Standardized Payment Amount |
16063.49 |
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 |
27 |
Number Of Medical Services |
116 |
Number Of Medicare Beneficiaries With Medical Services |
115 |
Total Medical Submitted Charge Amount |
108192 |
Total Medical Medicare Allowed Amount |
20541.37 |
Total Medical Medicare Payment Amount |
15954.4 |
Total Medical Medicare Standardized Payment Amount |
16063.49 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
59 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
102 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
91 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1795 |