National Provider Identifier [NPI]: |
1336400878 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
MELINDA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3100 E FLETCHER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336134613 |
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 |
40 |
Number Of Services |
158 |
Number Of Medicare Beneficiaries |
154 |
Total Submitted Charge Amount |
433411.65 |
Total Medicare Allowed Amount |
26679.55 |
Total Medicare Payment Amount |
20916.75 |
Total Medicare Standardized Payment Amount |
20305.69 |
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 |
40 |
Number Of Medical Services |
158 |
Number Of Medicare Beneficiaries With Medical Services |
154 |
Total Medical Submitted Charge Amount |
433411.65 |
Total Medical Medicare Allowed Amount |
26679.55 |
Total Medical Medicare Payment Amount |
20916.75 |
Total Medical Medicare Standardized Payment Amount |
20305.69 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7361 |