National Provider Identifier [NPI]: |
1891076873 |
Last Name Of The Provider |
HALE |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1431 CENTERPOINT BLVD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379321984 |
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 |
37 |
Number Of Services |
625 |
Number Of Medicare Beneficiaries |
467 |
Total Submitted Charge Amount |
506163 |
Total Medicare Allowed Amount |
58799.28 |
Total Medicare Payment Amount |
44015.89 |
Total Medicare Standardized Payment Amount |
54239.23 |
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 |
37 |
Number Of Medical Services |
625 |
Number Of Medicare Beneficiaries With Medical Services |
467 |
Total Medical Submitted Charge Amount |
506163 |
Total Medical Medicare Allowed Amount |
58799.28 |
Total Medical Medicare Payment Amount |
44015.89 |
Total Medical Medicare Standardized Payment Amount |
54239.23 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
247 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
282 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
300 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5839 |