National Provider Identifier [NPI]: |
1992929319 |
Last Name Of The Provider |
YIM |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
353 NEW SHACKLE ISLAND RD |
Street Address 2 Of The Provider |
BUILDING C, SUITE 140 |
City Of The Provider |
HENDERSONVILLE |
Zip Code Of The Provider |
370752379 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pediatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1486 |
Number Of Medicare Beneficiaries |
393 |
Total Submitted Charge Amount |
278679.27 |
Total Medicare Allowed Amount |
145642.54 |
Total Medicare Payment Amount |
111669.37 |
Total Medicare Standardized Payment Amount |
102538.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
715 |
Total Drug Medicare AllowedAmount |
298.45 |
Total Drug Medicare PaymentAmount |
281.02 |
Total Drug Medicare Standardized Payment Amount |
281.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
1467 |
Number Of Medicare Beneficiaries With Medical Services |
393 |
Total Medical Submitted Charge Amount |
277964.27 |
Total Medical Medicare Allowed Amount |
145344.09 |
Total Medical Medicare Payment Amount |
111388.35 |
Total Medical Medicare Standardized Payment Amount |
102257.77 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
366 |
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 |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
63 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.1809 |