National Provider Identifier [NPI]: |
1134367600 |
Last Name Of The Provider |
BOND |
First Name Of The Provider |
RUSSELL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2411 FOUNTAIN VIEW DR |
Street Address 2 Of The Provider |
STE. 200 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770574817 |
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 |
55 |
Number Of Services |
291 |
Number Of Medicare Beneficiaries |
283 |
Total Submitted Charge Amount |
784520 |
Total Medicare Allowed Amount |
75546.14 |
Total Medicare Payment Amount |
59075.94 |
Total Medicare Standardized Payment Amount |
60862.18 |
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 |
55 |
Number Of Medical Services |
291 |
Number Of Medicare Beneficiaries With Medical Services |
283 |
Total Medical Submitted Charge Amount |
784520 |
Total Medical Medicare Allowed Amount |
75546.14 |
Total Medical Medicare Payment Amount |
59075.94 |
Total Medical Medicare Standardized Payment Amount |
60862.18 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
247 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
258 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.6498 |