National Provider Identifier [NPI]: |
1952372013 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
KIMBER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12823 KINGSTON PIKE |
Street Address 2 Of The Provider |
FARRAGUT HEALTH CARE CENTER |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379340920 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Osteopathic Manipulative Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
734 |
Number Of Medicare Beneficiaries |
195 |
Total Submitted Charge Amount |
74215 |
Total Medicare Allowed Amount |
66171.04 |
Total Medicare Payment Amount |
48562.28 |
Total Medicare Standardized Payment Amount |
52484.32 |
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 |
11 |
Number Of Medical Services |
734 |
Number Of Medicare Beneficiaries With Medical Services |
195 |
Total Medical Submitted Charge Amount |
74215 |
Total Medical Medicare Allowed Amount |
66171.04 |
Total Medical Medicare Payment Amount |
48562.28 |
Total Medical Medicare Standardized Payment Amount |
52484.32 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
171 |
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 |
44 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
70 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
47 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3668 |