National Provider Identifier [NPI]: |
1174592984 |
Last Name Of The Provider |
DURAND |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
622 SMITHVIEW DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARYVILLE |
Zip Code Of The Provider |
378036100 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
382 |
Number Of Medicare Beneficiaries |
255 |
Total Submitted Charge Amount |
52888 |
Total Medicare Allowed Amount |
35768.64 |
Total Medicare Payment Amount |
22875.36 |
Total Medicare Standardized Payment Amount |
26000.67 |
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 |
15 |
Number Of Medical Services |
382 |
Number Of Medicare Beneficiaries With Medical Services |
255 |
Total Medical Submitted Charge Amount |
52888 |
Total Medical Medicare Allowed Amount |
35768.64 |
Total Medical Medicare Payment Amount |
22875.36 |
Total Medical Medicare Standardized Payment Amount |
26000.67 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
92 |
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 |
232 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9706 |