National Provider Identifier [NPI]: |
1396790176 |
Last Name Of The Provider |
DZAFERAGIC |
First Name Of The Provider |
MEVLIDA |
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 |
1755 KIRBY PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381204398 |
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 |
43 |
Number Of Services |
165 |
Number Of Medicare Beneficiaries |
159 |
Total Submitted Charge Amount |
191610.9 |
Total Medicare Allowed Amount |
43922.43 |
Total Medicare Payment Amount |
34224.15 |
Total Medicare Standardized Payment Amount |
36374.75 |
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 |
43 |
Number Of Medical Services |
165 |
Number Of Medicare Beneficiaries With Medical Services |
159 |
Total Medical Submitted Charge Amount |
191610.9 |
Total Medical Medicare Allowed Amount |
43922.43 |
Total Medical Medicare Payment Amount |
34224.15 |
Total Medical Medicare Standardized Payment Amount |
36374.75 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
75 |
Number Of Non Hispanic White Beneficiaries |
129 |
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 |
140 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5814 |