| National Provider Identifier [NPI]: | 1801896881 |
| Last Name Of The Provider | HINES |
| First Name Of The Provider | ELBERT |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6263 POPLAR AVE |
| Street Address 2 Of The Provider | SUITE 1052 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381194701 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 6486 |
| Number Of Medicare Beneficiaries | 1262 |
| Total Submitted Charge Amount | 1111453 |
| Total Medicare Allowed Amount | 502591.74 |
| Total Medicare Payment Amount | 370623.04 |
| Total Medicare Standardized Payment Amount | 392839.09 |
| 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 | 11 |
| Number Of Medical Services | 6486 |
| Number Of Medicare Beneficiaries With Medical Services | 1262 |
| Total Medical Submitted Charge Amount | 1111453 |
| Total Medical Medicare Allowed Amount | 502591.74 |
| Total Medical Medicare Payment Amount | 370623.04 |
| Total Medical Medicare Standardized Payment Amount | 392839.09 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 246 |
| Number Of Beneficiaries Age 75 to 84 | 395 |
| Number Of Beneficiaries Age Greater 84 | 483 |
| Number Of Female Beneficiaries | 848 |
| Number Of Male Beneficiaries | 414 |
| Number Of Non Hispanic White Beneficiaries | 813 |
| Number Of Black or African American Beneficiaries | 433 |
| 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 | 523 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 739 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 68 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 2.5611 |