National Provider Identifier [NPI]: |
1629417639 |
Last Name Of The Provider |
ELLIOTT |
First Name Of The Provider |
ALLISON |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2240 SUTHERLAND AVE |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379192333 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1528 |
Number Of Medicare Beneficiaries |
521 |
Total Submitted Charge Amount |
219604 |
Total Medicare Allowed Amount |
92573.81 |
Total Medicare Payment Amount |
72430.84 |
Total Medicare Standardized Payment Amount |
89483.1 |
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 |
17 |
Number Of Medical Services |
1528 |
Number Of Medicare Beneficiaries With Medical Services |
521 |
Total Medical Submitted Charge Amount |
219604 |
Total Medical Medicare Allowed Amount |
92573.81 |
Total Medical Medicare Payment Amount |
72430.84 |
Total Medical Medicare Standardized Payment Amount |
89483.1 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
164 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
118 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
491 |
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 |
385 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
136 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9421 |