National Provider Identifier [NPI]: |
1629242029 |
Last Name Of The Provider |
GARLAND |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4324 SUMMERFIELD DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
PINEY FLATS |
Zip Code Of The Provider |
376864560 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
2 |
Number Of Services |
330 |
Number Of Medicare Beneficiaries |
316 |
Total Submitted Charge Amount |
153090 |
Total Medicare Allowed Amount |
43177.47 |
Total Medicare Payment Amount |
32594.44 |
Total Medicare Standardized Payment Amount |
34558.55 |
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 |
2 |
Number Of Medical Services |
330 |
Number Of Medicare Beneficiaries With Medical Services |
316 |
Total Medical Submitted Charge Amount |
153090 |
Total Medical Medicare Allowed Amount |
43177.47 |
Total Medical Medicare Payment Amount |
32594.44 |
Total Medical Medicare Standardized Payment Amount |
34558.55 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
305 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
245 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2096 |