National Provider Identifier [NPI]: |
1043647845 |
Last Name Of The Provider |
LANDINO |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2800 MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRIDGEPORT |
Zip Code Of The Provider |
066064201 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
150 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
136667.25 |
Total Medicare Allowed Amount |
23424.31 |
Total Medicare Payment Amount |
18315.99 |
Total Medicare Standardized Payment Amount |
17353.76 |
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 |
50 |
Number Of Medical Services |
150 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
136667.25 |
Total Medical Medicare Allowed Amount |
23424.31 |
Total Medical Medicare Payment Amount |
18315.99 |
Total Medical Medicare Standardized Payment Amount |
17353.76 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
113 |
Number Of Black or African American Beneficiaries |
16 |
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 |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6255 |