National Provider Identifier [NPI]: |
1407894785 |
Last Name Of The Provider |
GRANDE |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
135 W RAVINE RD STE 5-B |
Street Address 2 Of The Provider |
AMERICAN ANESTHESIOLOGY GROUP OF TN, PC |
City Of The Provider |
KINGSPORT |
Zip Code Of The Provider |
376603847 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
313 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
502678 |
Total Medicare Allowed Amount |
45713.36 |
Total Medicare Payment Amount |
35190.87 |
Total Medicare Standardized Payment Amount |
37508.33 |
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 |
80 |
Number Of Medical Services |
313 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
502678 |
Total Medical Medicare Allowed Amount |
45713.36 |
Total Medical Medicare Payment Amount |
35190.87 |
Total Medical Medicare Standardized Payment Amount |
37508.33 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
88 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
147 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9248 |