National Provider Identifier [NPI]: |
1306068135 |
Last Name Of The Provider |
GRAHAM |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
979 EAST 3RD STREET |
Street Address 2 Of The Provider |
SUITE A0540/A0550 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
37403 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1383 |
Number Of Medicare Beneficiaries |
313 |
Total Submitted Charge Amount |
243663 |
Total Medicare Allowed Amount |
114570.26 |
Total Medicare Payment Amount |
84199.96 |
Total Medicare Standardized Payment Amount |
91167.66 |
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 |
17 |
Number Of Medical Services |
1383 |
Number Of Medicare Beneficiaries With Medical Services |
313 |
Total Medical Submitted Charge Amount |
243663 |
Total Medical Medicare Allowed Amount |
114570.26 |
Total Medical Medicare Payment Amount |
84199.96 |
Total Medical Medicare Standardized Payment Amount |
91167.66 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
270 |
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 |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
41 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.0326 |