National Provider Identifier [NPI]: |
1780765461 |
Last Name Of The Provider |
EL-CHEMEITELLI |
First Name Of The Provider |
SAMER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
525 DEVONIA ST STE A |
Street Address 2 Of The Provider |
|
City Of The Provider |
HARRIMAN |
Zip Code Of The Provider |
377482163 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1217 |
Number Of Medicare Beneficiaries |
366 |
Total Submitted Charge Amount |
207605 |
Total Medicare Allowed Amount |
89452.73 |
Total Medicare Payment Amount |
66078.91 |
Total Medicare Standardized Payment Amount |
71445.75 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
169 |
Number Of Non Hispanic White Beneficiaries |
353 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
69 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.8861 |