National Provider Identifier [NPI]: |
1538138805 |
Last Name Of The Provider |
HOUSE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1300 CLEVELAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374042005 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
120 |
Number Of Services |
10332 |
Number Of Medicare Beneficiaries |
761 |
Total Submitted Charge Amount |
883477 |
Total Medicare Allowed Amount |
326571.67 |
Total Medicare Payment Amount |
241834.76 |
Total Medicare Standardized Payment Amount |
266364.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
6362 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
69203 |
Total Drug Medicare AllowedAmount |
24728.75 |
Total Drug Medicare PaymentAmount |
18876.67 |
Total Drug Medicare Standardized Payment Amount |
18876.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
116 |
Number Of Medical Services |
3970 |
Number Of Medicare Beneficiaries With Medical Services |
761 |
Total Medical Submitted Charge Amount |
814274 |
Total Medical Medicare Allowed Amount |
301842.92 |
Total Medical Medicare Payment Amount |
222958.09 |
Total Medical Medicare Standardized Payment Amount |
247487.64 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
352 |
Number Of Beneficiaries Age 75 to 84 |
221 |
Number Of Beneficiaries Age Greater 84 |
83 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
519 |
Number Of Non Hispanic White Beneficiaries |
687 |
Number Of Black or African American Beneficiaries |
62 |
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 |
601 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
160 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4025 |