National Provider Identifier [NPI]: |
1295908150 |
Last Name Of The Provider |
KIMSEY |
First Name Of The Provider |
TROY |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1819 W CLINCH AVE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379162434 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Surgical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
500 |
Number Of Medicare Beneficiaries |
218 |
Total Submitted Charge Amount |
318757 |
Total Medicare Allowed Amount |
107198.97 |
Total Medicare Payment Amount |
79936.16 |
Total Medicare Standardized Payment Amount |
85095.68 |
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 |
87 |
Number Of Medical Services |
500 |
Number Of Medicare Beneficiaries With Medical Services |
218 |
Total Medical Submitted Charge Amount |
318757 |
Total Medical Medicare Allowed Amount |
107198.97 |
Total Medical Medicare Payment Amount |
79936.16 |
Total Medical Medicare Standardized Payment Amount |
85095.68 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
149 |
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 |
156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
38 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6458 |