National Provider Identifier [NPI]: |
1346275906 |
Last Name Of The Provider |
SIOSON-AHERRERA |
First Name Of The Provider |
PRISCILLA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
620 SKYLINE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383013923 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
3556 |
Number Of Medicare Beneficiaries |
586 |
Total Submitted Charge Amount |
481119 |
Total Medicare Allowed Amount |
301082.22 |
Total Medicare Payment Amount |
231540.4 |
Total Medicare Standardized Payment Amount |
246824.04 |
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 |
15 |
Number Of Medical Services |
3556 |
Number Of Medicare Beneficiaries With Medical Services |
586 |
Total Medical Submitted Charge Amount |
481119 |
Total Medical Medicare Allowed Amount |
301082.22 |
Total Medical Medicare Payment Amount |
231540.4 |
Total Medical Medicare Standardized Payment Amount |
246824.04 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
184 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
146 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
277 |
Number Of Male Beneficiaries |
309 |
Number Of Non Hispanic White Beneficiaries |
437 |
Number Of Black or African American Beneficiaries |
138 |
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 |
290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
296 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
70 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
3.034 |