National Provider Identifier [NPI]: |
1174509640 |
Last Name Of The Provider |
HAMMOCK |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
725 GLENWOOD DR |
Street Address 2 Of The Provider |
SUITE 480 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374041163 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
5271 |
Number Of Medicare Beneficiaries |
434 |
Total Submitted Charge Amount |
340559 |
Total Medicare Allowed Amount |
134938.6 |
Total Medicare Payment Amount |
106022.69 |
Total Medicare Standardized Payment Amount |
112676.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
1016 |
Number Of Medicare Beneficiaries With Drug Services |
152 |
Total Drug Submitted ChargeAmount |
16775 |
Total Drug Medicare AllowedAmount |
4482.74 |
Total Drug Medicare PaymentAmount |
3989.74 |
Total Drug Medicare Standardized Payment Amount |
3989.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
4255 |
Number Of Medicare Beneficiaries With Medical Services |
434 |
Total Medical Submitted Charge Amount |
323784 |
Total Medical Medicare Allowed Amount |
130455.86 |
Total Medical Medicare Payment Amount |
102032.95 |
Total Medical Medicare Standardized Payment Amount |
108686.55 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
207 |
Number Of Beneficiaries Age 75 to 84 |
146 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
340 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
392 |
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 |
413 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
31 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9615 |