National Provider Identifier [NPI]: |
1326191669 |
Last Name Of The Provider |
LOCKETTE |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
P.A.-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
189 BROOKLAWN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379342875 |
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 |
21 |
Number Of Services |
166 |
Number Of Medicare Beneficiaries |
103 |
Total Submitted Charge Amount |
9046 |
Total Medicare Allowed Amount |
6464.74 |
Total Medicare Payment Amount |
4555.42 |
Total Medicare Standardized Payment Amount |
5235.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
965 |
Total Drug Medicare AllowedAmount |
709.27 |
Total Drug Medicare PaymentAmount |
663.86 |
Total Drug Medicare Standardized Payment Amount |
663.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
130 |
Number Of Medicare Beneficiaries With Medical Services |
103 |
Total Medical Submitted Charge Amount |
8081 |
Total Medical Medicare Allowed Amount |
5755.47 |
Total Medical Medicare Payment Amount |
3891.56 |
Total Medical Medicare Standardized Payment Amount |
4571.32 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
70 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
90 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
16 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8244 |