National Provider Identifier [NPI]: |
1083632764 |
Last Name Of The Provider |
KRAFT |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
267 GRANT ST |
Street Address 2 Of The Provider |
BRIDGEPORT ANESTHESIA ASSOCIATES, P.C. |
City Of The Provider |
BRIDGEPORT |
Zip Code Of The Provider |
066102805 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
125 |
Number Of Medicare Beneficiaries |
123 |
Total Submitted Charge Amount |
69309.05 |
Total Medicare Allowed Amount |
13230.02 |
Total Medicare Payment Amount |
10372.3 |
Total Medicare Standardized Payment Amount |
9828.87 |
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 |
27 |
Number Of Medical Services |
125 |
Number Of Medicare Beneficiaries With Medical Services |
123 |
Total Medical Submitted Charge Amount |
69309.05 |
Total Medical Medicare Allowed Amount |
13230.02 |
Total Medical Medicare Payment Amount |
10372.3 |
Total Medical Medicare Standardized Payment Amount |
9828.87 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
104 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0795 |