National Provider Identifier [NPI]: |
1760569859 |
Last Name Of The Provider |
RIEGEL |
First Name Of The Provider |
DARRYL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
266 JOULE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALCOA |
Zip Code Of The Provider |
377012422 |
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 |
61 |
Number Of Services |
1703 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
138959.39 |
Total Medicare Allowed Amount |
88592 |
Total Medicare Payment Amount |
65430.64 |
Total Medicare Standardized Payment Amount |
70040.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
690 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
27043.67 |
Total Drug Medicare AllowedAmount |
12182.59 |
Total Drug Medicare PaymentAmount |
10411.7 |
Total Drug Medicare Standardized Payment Amount |
10411.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1013 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
111915.72 |
Total Medical Medicare Allowed Amount |
76409.41 |
Total Medical Medicare Payment Amount |
55018.94 |
Total Medical Medicare Standardized Payment Amount |
59629.02 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
114 |
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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.938 |