National Provider Identifier [NPI]: |
1780633966 |
Last Name Of The Provider |
AVGERIS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7205 WOLF RIVER BLVD |
Street Address 2 Of The Provider |
100 |
City Of The Provider |
GERMANTOWN |
Zip Code Of The Provider |
38138 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1323 |
Number Of Medicare Beneficiaries |
229 |
Total Submitted Charge Amount |
76502.58 |
Total Medicare Allowed Amount |
44208.64 |
Total Medicare Payment Amount |
31067.89 |
Total Medicare Standardized Payment Amount |
33888.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
412 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
4490.58 |
Total Drug Medicare AllowedAmount |
1292.98 |
Total Drug Medicare PaymentAmount |
792.8 |
Total Drug Medicare Standardized Payment Amount |
792.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
911 |
Number Of Medicare Beneficiaries With Medical Services |
229 |
Total Medical Submitted Charge Amount |
72012 |
Total Medical Medicare Allowed Amount |
42915.66 |
Total Medical Medicare Payment Amount |
30275.09 |
Total Medical Medicare Standardized Payment Amount |
33095.98 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
101 |
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 |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
7 |
Percent Of With Diabetes |
14 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7923 |