| National Provider Identifier [NPI]: | 1548263742 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | BERNADETTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 304 CHURCH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SWEETWATER |
| Zip Code Of The Provider | 378741181 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 2276 |
| Number Of Medicare Beneficiaries | 1038 |
| Total Submitted Charge Amount | 169721 |
| Total Medicare Allowed Amount | 43235.6 |
| Total Medicare Payment Amount | 30188.36 |
| Total Medicare Standardized Payment Amount | 32219.62 |
| 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 | 86 |
| Number Of Medical Services | 2276 |
| Number Of Medicare Beneficiaries With Medical Services | 1038 |
| Total Medical Submitted Charge Amount | 169721 |
| Total Medical Medicare Allowed Amount | 43235.6 |
| Total Medical Medicare Payment Amount | 30188.36 |
| Total Medical Medicare Standardized Payment Amount | 32219.62 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 279 |
| Number Of Beneficiaries Age 65 to 74 | 397 |
| Number Of Beneficiaries Age 75 to 84 | 232 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 643 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 998 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 637 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 401 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4039 |