National Provider Identifier [NPI]: |
1972690089 |
Last Name Of The Provider |
HERRELL |
First Name Of The Provider |
STANLEY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 TVC |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372320001 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
585 |
Number Of Medicare Beneficiaries |
278 |
Total Submitted Charge Amount |
582795.8 |
Total Medicare Allowed Amount |
127180.7 |
Total Medicare Payment Amount |
96200.29 |
Total Medicare Standardized Payment Amount |
104141.74 |
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 |
58 |
Number Of Medical Services |
585 |
Number Of Medicare Beneficiaries With Medical Services |
278 |
Total Medical Submitted Charge Amount |
582795.8 |
Total Medical Medicare Allowed Amount |
127180.7 |
Total Medical Medicare Payment Amount |
96200.29 |
Total Medical Medicare Standardized Payment Amount |
104141.74 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
253 |
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 |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
71 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6695 |