National Provider Identifier [NPI]: |
1124035571 |
Last Name Of The Provider |
ALLAN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2341 MCCALLIE AVE |
Street Address 2 Of The Provider |
PLAZA III, STE 200 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374043239 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiac Electrophysiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
6005 |
Number Of Medicare Beneficiaries |
1097 |
Total Submitted Charge Amount |
1237490 |
Total Medicare Allowed Amount |
582537.65 |
Total Medicare Payment Amount |
433873.01 |
Total Medicare Standardized Payment Amount |
478186.75 |
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 |
78 |
Number Of Medical Services |
6005 |
Number Of Medicare Beneficiaries With Medical Services |
1097 |
Total Medical Submitted Charge Amount |
1237490 |
Total Medical Medicare Allowed Amount |
582537.65 |
Total Medical Medicare Payment Amount |
433873.01 |
Total Medical Medicare Standardized Payment Amount |
478186.75 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
404 |
Number Of Beneficiaries Age 75 to 84 |
409 |
Number Of Beneficiaries Age Greater 84 |
167 |
Number Of Female Beneficiaries |
511 |
Number Of Male Beneficiaries |
586 |
Number Of Non Hispanic White Beneficiaries |
1015 |
Number Of Black or African American Beneficiaries |
66 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
908 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
49 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7365 |