National Provider Identifier [NPI]: |
1235361213 |
Last Name Of The Provider |
HARGIS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
341 TRANE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379196053 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
238 |
Number Of Medicare Beneficiaries |
233 |
Total Submitted Charge Amount |
315015 |
Total Medicare Allowed Amount |
44422.69 |
Total Medicare Payment Amount |
34555.9 |
Total Medicare Standardized Payment Amount |
36694.69 |
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 |
51 |
Number Of Medical Services |
238 |
Number Of Medicare Beneficiaries With Medical Services |
233 |
Total Medical Submitted Charge Amount |
315015 |
Total Medical Medicare Allowed Amount |
44422.69 |
Total Medical Medicare Payment Amount |
34555.9 |
Total Medical Medicare Standardized Payment Amount |
36694.69 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
99 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
208 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.5659 |