National Provider Identifier [NPI]: |
1477714442 |
Last Name Of The Provider |
ROA |
First Name Of The Provider |
DESIREE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10820 PARKSIDE DR |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379341956 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1241 |
Number Of Medicare Beneficiaries |
391 |
Total Submitted Charge Amount |
197302 |
Total Medicare Allowed Amount |
126317.16 |
Total Medicare Payment Amount |
96746.14 |
Total Medicare Standardized Payment Amount |
103329.82 |
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 |
16 |
Number Of Medical Services |
1241 |
Number Of Medicare Beneficiaries With Medical Services |
391 |
Total Medical Submitted Charge Amount |
197302 |
Total Medical Medicare Allowed Amount |
126317.16 |
Total Medical Medicare Payment Amount |
96746.14 |
Total Medical Medicare Standardized Payment Amount |
103329.82 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
375 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
265 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3018 |