National Provider Identifier [NPI]: |
1154662872 |
Last Name Of The Provider |
BURCH |
First Name Of The Provider |
ROBIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
APRN-CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1611 S UTICA AVE |
Street Address 2 Of The Provider |
STE 217 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741044909 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
198 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
253890 |
Total Medicare Allowed Amount |
59438.93 |
Total Medicare Payment Amount |
45821.5 |
Total Medicare Standardized Payment Amount |
47636.29 |
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 |
59 |
Number Of Medical Services |
198 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
253890 |
Total Medical Medicare Allowed Amount |
59438.93 |
Total Medical Medicare Payment Amount |
45821.5 |
Total Medical Medicare Standardized Payment Amount |
47636.29 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
151 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
20 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.3557 |