National Provider Identifier [NPI]: |
1750498929 |
Last Name Of The Provider |
LECRAW |
First Name Of The Provider |
DEBORAH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 N STATE OF FRANKLIN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376046035 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
511 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
410980 |
Total Medicare Allowed Amount |
62558.55 |
Total Medicare Payment Amount |
48161.77 |
Total Medicare Standardized Payment Amount |
50688.54 |
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 |
20 |
Number Of Medical Services |
511 |
Number Of Medicare Beneficiaries With Medical Services |
360 |
Total Medical Submitted Charge Amount |
410980 |
Total Medical Medicare Allowed Amount |
62558.55 |
Total Medical Medicare Payment Amount |
48161.77 |
Total Medical Medicare Standardized Payment Amount |
50688.54 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
142 |
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 |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
152 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6213 |