National Provider Identifier [NPI]: |
1588760938 |
Last Name Of The Provider |
DAVIS |
First Name Of The Provider |
MELISSA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1224 TROTWOOD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIA |
Zip Code Of The Provider |
384014802 |
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 |
40 |
Number Of Services |
366 |
Number Of Medicare Beneficiaries |
344 |
Total Submitted Charge Amount |
231152 |
Total Medicare Allowed Amount |
40337.24 |
Total Medicare Payment Amount |
31585.57 |
Total Medicare Standardized Payment Amount |
33424.53 |
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 |
366 |
Number Of Medicare Beneficiaries With Medical Services |
344 |
Total Medical Submitted Charge Amount |
231152 |
Total Medical Medicare Allowed Amount |
40337.24 |
Total Medical Medicare Payment Amount |
31585.57 |
Total Medical Medicare Standardized Payment Amount |
33424.53 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
183 |
Number Of Male Beneficiaries |
161 |
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 |
247 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3673 |