National Provider Identifier [NPI]: |
1023016508 |
Last Name Of The Provider |
FRAZIER |
First Name Of The Provider |
MILES |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1900 PINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ABILENE |
Zip Code Of The Provider |
796012432 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
263 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
238423 |
Total Medicare Allowed Amount |
31250.98 |
Total Medicare Payment Amount |
24129.9 |
Total Medicare Standardized Payment Amount |
24910.04 |
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 |
52 |
Number Of Medical Services |
263 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
238423 |
Total Medical Medicare Allowed Amount |
31250.98 |
Total Medical Medicare Payment Amount |
24129.9 |
Total Medical Medicare Standardized Payment Amount |
24910.04 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
114 |
Number Of Non Hispanic White Beneficiaries |
206 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5454 |