National Provider Identifier [NPI]: |
1821180241 |
Last Name Of The Provider |
MAYNARD |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
|
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 |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
724 |
Number Of Medicare Beneficiaries |
359 |
Total Submitted Charge Amount |
163910 |
Total Medicare Allowed Amount |
51891.75 |
Total Medicare Payment Amount |
34111.3 |
Total Medicare Standardized Payment Amount |
37328.06 |
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 |
23 |
Number Of Medical Services |
724 |
Number Of Medicare Beneficiaries With Medical Services |
359 |
Total Medical Submitted Charge Amount |
163910 |
Total Medical Medicare Allowed Amount |
51891.75 |
Total Medical Medicare Payment Amount |
34111.3 |
Total Medical Medicare Standardized Payment Amount |
37328.06 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
189 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
295 |
Number Of Black or African American Beneficiaries |
46 |
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 |
302 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2472 |