National Provider Identifier [NPI]: |
1457546053 |
Last Name Of The Provider |
EVANS |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11110 MEDICAL CAMPUS RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
HAGERSTOWN |
Zip Code Of The Provider |
217426700 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
510 |
Number Of Medicare Beneficiaries |
447 |
Total Submitted Charge Amount |
358974 |
Total Medicare Allowed Amount |
50166.36 |
Total Medicare Payment Amount |
38548.26 |
Total Medicare Standardized Payment Amount |
38619.85 |
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 |
19 |
Number Of Medical Services |
510 |
Number Of Medicare Beneficiaries With Medical Services |
447 |
Total Medical Submitted Charge Amount |
358974 |
Total Medical Medicare Allowed Amount |
50166.36 |
Total Medical Medicare Payment Amount |
38548.26 |
Total Medical Medicare Standardized Payment Amount |
38619.85 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
227 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
406 |
Number Of Black or African American Beneficiaries |
29 |
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 |
412 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0131 |