National Provider Identifier [NPI]: |
1730151994 |
Last Name Of The Provider |
LISY |
First Name Of The Provider |
ONDREJ |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2501 CITICO AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374041127 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
6061 |
Number Of Medicare Beneficiaries |
3156 |
Total Submitted Charge Amount |
1057610 |
Total Medicare Allowed Amount |
298855.34 |
Total Medicare Payment Amount |
220971.38 |
Total Medicare Standardized Payment Amount |
237075.12 |
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 |
51 |
Number Of Medical Services |
6061 |
Number Of Medicare Beneficiaries With Medical Services |
3156 |
Total Medical Submitted Charge Amount |
1057610 |
Total Medical Medicare Allowed Amount |
298855.34 |
Total Medical Medicare Payment Amount |
220971.38 |
Total Medical Medicare Standardized Payment Amount |
237075.12 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
393 |
Number Of Beneficiaries Age 65 to 74 |
1268 |
Number Of Beneficiaries Age 75 to 84 |
1015 |
Number Of Beneficiaries Age Greater 84 |
480 |
Number Of Female Beneficiaries |
1621 |
Number Of Male Beneficiaries |
1535 |
Number Of Non Hispanic White Beneficiaries |
2901 |
Number Of Black or African American Beneficiaries |
207 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
2633 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
523 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5452 |