National Provider Identifier [NPI]: |
1851398259 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
ALLEN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2240 SUTHERLAND AVE |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379192333 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
1368 |
Number Of Medicare Beneficiaries |
389 |
Total Submitted Charge Amount |
383323 |
Total Medicare Allowed Amount |
173406.08 |
Total Medicare Payment Amount |
134737.21 |
Total Medicare Standardized Payment Amount |
141678.21 |
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 |
32 |
Number Of Medical Services |
1368 |
Number Of Medicare Beneficiaries With Medical Services |
389 |
Total Medical Submitted Charge Amount |
383323 |
Total Medical Medicare Allowed Amount |
173406.08 |
Total Medical Medicare Payment Amount |
134737.21 |
Total Medical Medicare Standardized Payment Amount |
141678.21 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
368 |
Number Of Black or African American Beneficiaries |
|
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 |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
154 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
65 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
70 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.5337 |