National Provider Identifier [NPI]: |
1528086709 |
Last Name Of The Provider |
COWLEY |
First Name Of The Provider |
NANCY |
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 |
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 |
18 |
Number Of Services |
216 |
Number Of Medicare Beneficiaries |
213 |
Total Submitted Charge Amount |
377429.8 |
Total Medicare Allowed Amount |
23469.87 |
Total Medicare Payment Amount |
18235.28 |
Total Medicare Standardized Payment Amount |
17693.35 |
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 |
18 |
Number Of Medical Services |
216 |
Number Of Medicare Beneficiaries With Medical Services |
213 |
Total Medical Submitted Charge Amount |
377429.8 |
Total Medical Medicare Allowed Amount |
23469.87 |
Total Medical Medicare Payment Amount |
18235.28 |
Total Medical Medicare Standardized Payment Amount |
17693.35 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
166 |
Number Of Black or African American Beneficiaries |
22 |
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 |
159 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0381 |