National Provider Identifier [NPI]: |
1730146564 |
Last Name Of The Provider |
SELLHEYER |
First Name Of The Provider |
KLAUS |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2358 LIFESTYLE WAY |
Street Address 2 Of The Provider |
SUITE 212 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374212291 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
841 |
Number Of Medicare Beneficiaries |
446 |
Total Submitted Charge Amount |
129450 |
Total Medicare Allowed Amount |
55334.36 |
Total Medicare Payment Amount |
36081.15 |
Total Medicare Standardized Payment Amount |
30732.57 |
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 |
26 |
Number Of Medical Services |
841 |
Number Of Medicare Beneficiaries With Medical Services |
446 |
Total Medical Submitted Charge Amount |
129450 |
Total Medical Medicare Allowed Amount |
55334.36 |
Total Medical Medicare Payment Amount |
36081.15 |
Total Medical Medicare Standardized Payment Amount |
30732.57 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
178 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
211 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
420 |
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 |
418 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0453 |