National Provider Identifier [NPI]: |
1073524906 |
Last Name Of The Provider |
HUDDLESTON |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1800 MEDICAL CENTER PKWY |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
371292567 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
882 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
225389 |
Total Medicare Allowed Amount |
47635.27 |
Total Medicare Payment Amount |
35457.42 |
Total Medicare Standardized Payment Amount |
42212.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
236 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
42523 |
Total Drug Medicare AllowedAmount |
12513.85 |
Total Drug Medicare PaymentAmount |
9587.52 |
Total Drug Medicare Standardized Payment Amount |
9587.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
646 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
182866 |
Total Medical Medicare Allowed Amount |
35121.42 |
Total Medical Medicare Payment Amount |
25869.9 |
Total Medical Medicare Standardized Payment Amount |
32624.79 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
186 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1671 |