National Provider Identifier [NPI]: |
1508171372 |
Last Name Of The Provider |
RISEDEN |
First Name Of The Provider |
DEREK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP-BC, NP-C |
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 |
STE 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 |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
68 |
Number Of Services |
1546 |
Number Of Medicare Beneficiaries |
426 |
Total Submitted Charge Amount |
202346 |
Total Medicare Allowed Amount |
62111.59 |
Total Medicare Payment Amount |
46190.04 |
Total Medicare Standardized Payment Amount |
56409.86 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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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 |
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Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
315 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
366 |
Number Of Black or African American Beneficiaries |
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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 |
128 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
298 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.4544 |