National Provider Identifier [NPI]: |
1104154194 |
Last Name Of The Provider |
GREENWAY |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 PRINCETON AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352111303 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
389 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
147300 |
Total Medicare Allowed Amount |
25973.64 |
Total Medicare Payment Amount |
20069.45 |
Total Medicare Standardized Payment Amount |
21613.66 |
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 |
42 |
Number Of Medical Services |
389 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
147300 |
Total Medical Medicare Allowed Amount |
25973.64 |
Total Medical Medicare Payment Amount |
20069.45 |
Total Medical Medicare Standardized Payment Amount |
21613.66 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
170 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
318 |
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 |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1409 |