National Provider Identifier [NPI]: |
1740282755 |
Last Name Of The Provider |
KIRBY |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5715 CORNELISON RD |
Street Address 2 Of The Provider |
6600 BLDG |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374115661 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
8175 |
Number Of Medicare Beneficiaries |
1769 |
Total Submitted Charge Amount |
1833668 |
Total Medicare Allowed Amount |
736660.74 |
Total Medicare Payment Amount |
523622.1 |
Total Medicare Standardized Payment Amount |
580225.87 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
761 |
Number Of Beneficiaries Age 75 to 84 |
649 |
Number Of Beneficiaries Age Greater 84 |
251 |
Number Of Female Beneficiaries |
1023 |
Number Of Male Beneficiaries |
746 |
Number Of Non Hispanic White Beneficiaries |
1492 |
Number Of Black or African American Beneficiaries |
247 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
1624 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
145 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0627 |