National Provider Identifier [NPI]: |
1194722132 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
JANE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
110 29TH AVE N |
Street Address 2 Of The Provider |
STE 202 |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372031401 |
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 |
60 |
Number Of Services |
216 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
204523.3 |
Total Medicare Allowed Amount |
28394.95 |
Total Medicare Payment Amount |
22155.49 |
Total Medicare Standardized Payment Amount |
23669.6 |
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 |
60 |
Number Of Medical Services |
216 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
204523.3 |
Total Medical Medicare Allowed Amount |
28394.95 |
Total Medical Medicare Payment Amount |
22155.49 |
Total Medical Medicare Standardized Payment Amount |
23669.6 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
97 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
164 |
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 |
160 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2659 |