National Provider Identifier [NPI]: |
1316971203 |
Last Name Of The Provider |
FERGUSON |
First Name Of The Provider |
RODNEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
266 JOULE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALCOA |
Zip Code Of The Provider |
377012422 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1148 |
Number Of Medicare Beneficiaries |
157 |
Total Submitted Charge Amount |
101314.85 |
Total Medicare Allowed Amount |
64543.37 |
Total Medicare Payment Amount |
47641.3 |
Total Medicare Standardized Payment Amount |
51547.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
452 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
22132.94 |
Total Drug Medicare AllowedAmount |
10425.82 |
Total Drug Medicare PaymentAmount |
9188.94 |
Total Drug Medicare Standardized Payment Amount |
9188.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
696 |
Number Of Medicare Beneficiaries With Medical Services |
157 |
Total Medical Submitted Charge Amount |
79181.91 |
Total Medical Medicare Allowed Amount |
54117.55 |
Total Medical Medicare Payment Amount |
38452.36 |
Total Medical Medicare Standardized Payment Amount |
42358.72 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
146 |
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 |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9358 |