National Provider Identifier [NPI]: |
1497082895 |
Last Name Of The Provider |
GARCIA |
First Name Of The Provider |
GERARDO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 BROOKSIDE DR |
Street Address 2 Of The Provider |
3RD FLOOR |
City Of The Provider |
KINGSPORT |
Zip Code Of The Provider |
376604627 |
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 |
23 |
Number Of Services |
969 |
Number Of Medicare Beneficiaries |
319 |
Total Submitted Charge Amount |
222626 |
Total Medicare Allowed Amount |
101221.83 |
Total Medicare Payment Amount |
78290.25 |
Total Medicare Standardized Payment Amount |
82971.78 |
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 |
23 |
Number Of Medical Services |
969 |
Number Of Medicare Beneficiaries With Medical Services |
319 |
Total Medical Submitted Charge Amount |
222626 |
Total Medical Medicare Allowed Amount |
101221.83 |
Total Medical Medicare Payment Amount |
78290.25 |
Total Medical Medicare Standardized Payment Amount |
82971.78 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
89 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
124 |
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 |
188 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.242 |