National Provider Identifier [NPI]: |
1184644965 |
Last Name Of The Provider |
POHLOD-MARTIN |
First Name Of The Provider |
LYDIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11800 E 12 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARREN |
Zip Code Of The Provider |
480933472 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
739 |
Number Of Medicare Beneficiaries |
693 |
Total Submitted Charge Amount |
391578.93 |
Total Medicare Allowed Amount |
80151.17 |
Total Medicare Payment Amount |
61795.6 |
Total Medicare Standardized Payment Amount |
58955.84 |
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 |
29 |
Number Of Medical Services |
739 |
Number Of Medicare Beneficiaries With Medical Services |
693 |
Total Medical Submitted Charge Amount |
391578.93 |
Total Medical Medicare Allowed Amount |
80151.17 |
Total Medical Medicare Payment Amount |
61795.6 |
Total Medical Medicare Standardized Payment Amount |
58955.84 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
354 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
395 |
Number Of Male Beneficiaries |
298 |
Number Of Non Hispanic White Beneficiaries |
589 |
Number Of Black or African American Beneficiaries |
65 |
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 |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
607 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
86 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2833 |