National Provider Identifier [NPI]: |
1487608170 |
Last Name Of The Provider |
DISMUKES |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6263 POPLAR AVE |
Street Address 2 Of The Provider |
# 1052 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381194701 |
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 |
14 |
Number Of Services |
3955 |
Number Of Medicare Beneficiaries |
579 |
Total Submitted Charge Amount |
676340 |
Total Medicare Allowed Amount |
347422.78 |
Total Medicare Payment Amount |
268011.78 |
Total Medicare Standardized Payment Amount |
283444.24 |
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 |
14 |
Number Of Medical Services |
3955 |
Number Of Medicare Beneficiaries With Medical Services |
579 |
Total Medical Submitted Charge Amount |
676340 |
Total Medical Medicare Allowed Amount |
347422.78 |
Total Medical Medicare Payment Amount |
268011.78 |
Total Medical Medicare Standardized Payment Amount |
283444.24 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
201 |
Number Of Beneficiaries Age Greater 84 |
165 |
Number Of Female Beneficiaries |
358 |
Number Of Male Beneficiaries |
221 |
Number Of Non Hispanic White Beneficiaries |
445 |
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 |
456 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
57 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.6628 |