National Provider Identifier [NPI]: |
1780094680 |
Last Name Of The Provider |
CUNNINGHAM |
First Name Of The Provider |
KELLEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1342 PAPERMILL POINTE WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379091903 |
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 |
58 |
Number Of Services |
27910 |
Number Of Medicare Beneficiaries |
551 |
Total Submitted Charge Amount |
1637245.32 |
Total Medicare Allowed Amount |
799063.82 |
Total Medicare Payment Amount |
759516.69 |
Total Medicare Standardized Payment Amount |
638991.99 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
466 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
286 |
Number Of Non Hispanic White Beneficiaries |
502 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
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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 |
173 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
378 |
Percent Of With Atrial Fibrillation |
2 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
3 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3636 |