National Provider Identifier [NPI]: |
1235131038 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
ARTHUR |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1924 ALCOA HWY |
Street Address 2 Of The Provider |
BOX U109 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379201511 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
202 |
Number Of Medicare Beneficiaries |
178 |
Total Submitted Charge Amount |
292880 |
Total Medicare Allowed Amount |
24913.89 |
Total Medicare Payment Amount |
19484.57 |
Total Medicare Standardized Payment Amount |
21102.11 |
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 |
74 |
Number Of Medical Services |
202 |
Number Of Medicare Beneficiaries With Medical Services |
178 |
Total Medical Submitted Charge Amount |
292880 |
Total Medical Medicare Allowed Amount |
24913.89 |
Total Medical Medicare Payment Amount |
19484.57 |
Total Medical Medicare Standardized Payment Amount |
21102.11 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
59 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
162 |
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 |
126 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
2.6364 |