National Provider Identifier [NPI]: |
1578626073 |
Last Name Of The Provider |
HULL |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 E BLOUNT AVE |
Street Address 2 Of The Provider |
SUITE 507 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379201614 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
699 |
Number Of Medicare Beneficiaries |
590 |
Total Submitted Charge Amount |
608755 |
Total Medicare Allowed Amount |
95622.58 |
Total Medicare Payment Amount |
73841.47 |
Total Medicare Standardized Payment Amount |
77620.49 |
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 |
34 |
Number Of Medical Services |
699 |
Number Of Medicare Beneficiaries With Medical Services |
590 |
Total Medical Submitted Charge Amount |
608755 |
Total Medical Medicare Allowed Amount |
95622.58 |
Total Medical Medicare Payment Amount |
73841.47 |
Total Medical Medicare Standardized Payment Amount |
77620.49 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
226 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
137 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
331 |
Number Of Male Beneficiaries |
259 |
Number Of Non Hispanic White Beneficiaries |
471 |
Number Of Black or African American Beneficiaries |
107 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
331 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
259 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9852 |