National Provider Identifier [NPI]: |
1598844359 |
Last Name Of The Provider |
CANNADAY |
First Name Of The Provider |
RODNEY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3610 N UNIVERSITY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
NACOGDOCHES |
Zip Code Of The Provider |
759652539 |
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 |
19 |
Number Of Services |
365 |
Number Of Medicare Beneficiaries |
305 |
Total Submitted Charge Amount |
168000 |
Total Medicare Allowed Amount |
49722.21 |
Total Medicare Payment Amount |
38534.36 |
Total Medicare Standardized Payment Amount |
39950.93 |
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 |
365 |
Number Of Medicare Beneficiaries With Medical Services |
305 |
Total Medical Submitted Charge Amount |
168000 |
Total Medical Medicare Allowed Amount |
49722.21 |
Total Medical Medicare Payment Amount |
38534.36 |
Total Medical Medicare Standardized Payment Amount |
39950.93 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
127 |
Number Of Non Hispanic White Beneficiaries |
229 |
Number Of Black or African American Beneficiaries |
63 |
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 |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6935 |