National Provider Identifier [NPI]: |
1013960905 |
Last Name Of The Provider |
NUNES |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1710 GUNBARREL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374213127 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
189 |
Number Of Services |
10603 |
Number Of Medicare Beneficiaries |
2496 |
Total Submitted Charge Amount |
1032268.47 |
Total Medicare Allowed Amount |
217265.35 |
Total Medicare Payment Amount |
168921.92 |
Total Medicare Standardized Payment Amount |
186101.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
6756 |
Number Of Medicare Beneficiaries With Drug Services |
120 |
Total Drug Submitted ChargeAmount |
13218.49 |
Total Drug Medicare AllowedAmount |
4564.12 |
Total Drug Medicare PaymentAmount |
3517.71 |
Total Drug Medicare Standardized Payment Amount |
3517.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
179 |
Number Of Medical Services |
3847 |
Number Of Medicare Beneficiaries With Medical Services |
2495 |
Total Medical Submitted Charge Amount |
1019049.98 |
Total Medical Medicare Allowed Amount |
212701.23 |
Total Medical Medicare Payment Amount |
165404.21 |
Total Medical Medicare Standardized Payment Amount |
182584.12 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
611 |
Number Of Beneficiaries Age 65 to 74 |
977 |
Number Of Beneficiaries Age 75 to 84 |
646 |
Number Of Beneficiaries Age Greater 84 |
262 |
Number Of Female Beneficiaries |
1595 |
Number Of Male Beneficiaries |
901 |
Number Of Non Hispanic White Beneficiaries |
2180 |
Number Of Black or African American Beneficiaries |
261 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
1716 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
780 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6263 |