National Provider Identifier [NPI]: |
1619957248 |
Last Name Of The Provider |
ROULIER |
First Name Of The Provider |
GAYLE |
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 |
2001 LAUREL AVE |
Street Address 2 Of The Provider |
SUITE N304 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379161810 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
3047 |
Number Of Medicare Beneficiaries |
1371 |
Total Submitted Charge Amount |
282249 |
Total Medicare Allowed Amount |
67101.31 |
Total Medicare Payment Amount |
59312.31 |
Total Medicare Standardized Payment Amount |
62832.31 |
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 |
19 |
Number Of Medical Services |
3047 |
Number Of Medicare Beneficiaries With Medical Services |
1371 |
Total Medical Submitted Charge Amount |
282249 |
Total Medical Medicare Allowed Amount |
67101.31 |
Total Medical Medicare Payment Amount |
59312.31 |
Total Medical Medicare Standardized Payment Amount |
62832.31 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
195 |
Number Of Beneficiaries Age 65 to 74 |
735 |
Number Of Beneficiaries Age 75 to 84 |
352 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
1360 |
Number Of Male Beneficiaries |
11 |
Number Of Non Hispanic White Beneficiaries |
1207 |
Number Of Black or African American Beneficiaries |
140 |
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 |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
1162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
209 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.8824 |