National Provider Identifier [NPI]: |
1952349151 |
Last Name Of The Provider |
WARNER |
First Name Of The Provider |
RONNIE |
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 |
5959 PARK AVE |
Street Address 2 Of The Provider |
RADIOLOGY DEPARTMENT |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381195200 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
254 |
Number Of Services |
8749 |
Number Of Medicare Beneficiaries |
2350 |
Total Submitted Charge Amount |
782553.2 |
Total Medicare Allowed Amount |
160876.75 |
Total Medicare Payment Amount |
121074.99 |
Total Medicare Standardized Payment Amount |
134199.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
5057 |
Number Of Medicare Beneficiaries With Drug Services |
53 |
Total Drug Submitted ChargeAmount |
7306.2 |
Total Drug Medicare AllowedAmount |
1145.21 |
Total Drug Medicare PaymentAmount |
849.25 |
Total Drug Medicare Standardized Payment Amount |
849.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
250 |
Number Of Medical Services |
3692 |
Number Of Medicare Beneficiaries With Medical Services |
2350 |
Total Medical Submitted Charge Amount |
775247 |
Total Medical Medicare Allowed Amount |
159731.54 |
Total Medical Medicare Payment Amount |
120225.74 |
Total Medical Medicare Standardized Payment Amount |
133350.68 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
587 |
Number Of Beneficiaries Age 65 to 74 |
836 |
Number Of Beneficiaries Age 75 to 84 |
602 |
Number Of Beneficiaries Age Greater 84 |
325 |
Number Of Female Beneficiaries |
1458 |
Number Of Male Beneficiaries |
892 |
Number Of Non Hispanic White Beneficiaries |
1489 |
Number Of Black or African American Beneficiaries |
804 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
1529 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
821 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.0518 |