National Provider Identifier [NPI]: |
1750354155 |
Last Name Of The Provider |
WIGHT |
First Name Of The Provider |
CLINTON |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
230 ASSOCIATES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALCOA |
Zip Code Of The Provider |
377011943 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
1862 |
Number Of Medicare Beneficiaries |
252 |
Total Submitted Charge Amount |
124258.02 |
Total Medicare Allowed Amount |
82370.9 |
Total Medicare Payment Amount |
60035.38 |
Total Medicare Standardized Payment Amount |
66173.77 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
16 |
Number Of Drug Services |
680 |
Number Of Medicare Beneficiaries With Drug Services |
170 |
Total Drug Submitted ChargeAmount |
30739.02 |
Total Drug Medicare AllowedAmount |
15931.26 |
Total Drug Medicare PaymentAmount |
14668.65 |
Total Drug Medicare Standardized Payment Amount |
14668.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
1182 |
Number Of Medicare Beneficiaries With Medical Services |
252 |
Total Medical Submitted Charge Amount |
93519 |
Total Medical Medicare Allowed Amount |
66439.64 |
Total Medical Medicare Payment Amount |
45366.73 |
Total Medical Medicare Standardized Payment Amount |
51505.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
109 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9477 |