National Provider Identifier [NPI]: |
1972540672 |
Last Name Of The Provider |
LI |
First Name Of The Provider |
JUN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD, PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
A-0118 MEDICAL CTR N |
Street Address 2 Of The Provider |
DEPARTMENT OF NEUROLOGY |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372320001 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
115 |
Number Of Medicare Beneficiaries |
70 |
Total Submitted Charge Amount |
32260 |
Total Medicare Allowed Amount |
8826.32 |
Total Medicare Payment Amount |
6284.17 |
Total Medicare Standardized Payment Amount |
6567.52 |
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 |
115 |
Number Of Medicare Beneficiaries With Medical Services |
70 |
Total Medical Submitted Charge Amount |
32260 |
Total Medical Medicare Allowed Amount |
8826.32 |
Total Medical Medicare Payment Amount |
6284.17 |
Total Medical Medicare Standardized Payment Amount |
6567.52 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
31 |
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 |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5355 |