National Provider Identifier [NPI]: |
1427052224 |
Last Name Of The Provider |
PEACOCK |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 20TH AVE N |
Street Address 2 Of The Provider |
SUITE G-4 |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372032131 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1498 |
Number Of Medicare Beneficiaries |
486 |
Total Submitted Charge Amount |
440907.82 |
Total Medicare Allowed Amount |
167142.37 |
Total Medicare Payment Amount |
127019.81 |
Total Medicare Standardized Payment Amount |
136306.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1292 |
Total Drug Medicare AllowedAmount |
596.29 |
Total Drug Medicare PaymentAmount |
575.54 |
Total Drug Medicare Standardized Payment Amount |
575.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
1473 |
Number Of Medicare Beneficiaries With Medical Services |
486 |
Total Medical Submitted Charge Amount |
439615.82 |
Total Medical Medicare Allowed Amount |
166546.08 |
Total Medical Medicare Payment Amount |
126444.27 |
Total Medical Medicare Standardized Payment Amount |
135730.74 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
209 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
402 |
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 |
362 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9696 |