National Provider Identifier [NPI]: |
1356442636 |
Last Name Of The Provider |
PROFFITT |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
118 MAUPIN CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHELBYVILLE |
Zip Code Of The Provider |
371603781 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychologist (billing independently) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
644 |
Number Of Medicare Beneficiaries |
302 |
Total Submitted Charge Amount |
79270 |
Total Medicare Allowed Amount |
57230.98 |
Total Medicare Payment Amount |
44855.87 |
Total Medicare Standardized Payment Amount |
46646.16 |
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 |
5 |
Number Of Medical Services |
644 |
Number Of Medicare Beneficiaries With Medical Services |
302 |
Total Medical Submitted Charge Amount |
79270 |
Total Medical Medicare Allowed Amount |
57230.98 |
Total Medical Medicare Payment Amount |
44855.87 |
Total Medical Medicare Standardized Payment Amount |
46646.16 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
239 |
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 |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
235 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
69 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
57 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1895 |