National Provider Identifier [NPI]: |
1215166384 |
Last Name Of The Provider |
RUSSELL |
First Name Of The Provider |
JOY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5701 BRAINERD RD |
Street Address 2 Of The Provider |
SUITE 111 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374114016 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
854 |
Number Of Medicare Beneficiaries |
189 |
Total Submitted Charge Amount |
102655.67 |
Total Medicare Allowed Amount |
40487.31 |
Total Medicare Payment Amount |
29928.17 |
Total Medicare Standardized Payment Amount |
32279.72 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
103 |
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 |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
74 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
71 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.1087 |