National Provider Identifier [NPI]: |
1336102912 |
Last Name Of The Provider |
LYNN |
First Name Of The Provider |
KENNY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
210 W. CEDAR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COOKEVILLE |
Zip Code Of The Provider |
385012419 |
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 |
43 |
Number Of Services |
3496 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
214667 |
Total Medicare Allowed Amount |
152097.51 |
Total Medicare Payment Amount |
105627.78 |
Total Medicare Standardized Payment Amount |
116803.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
809 |
Number Of Medicare Beneficiaries With Drug Services |
182 |
Total Drug Submitted ChargeAmount |
16120 |
Total Drug Medicare AllowedAmount |
4827.11 |
Total Drug Medicare PaymentAmount |
3992.8 |
Total Drug Medicare Standardized Payment Amount |
3992.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
2687 |
Number Of Medicare Beneficiaries With Medical Services |
408 |
Total Medical Submitted Charge Amount |
198547 |
Total Medical Medicare Allowed Amount |
147270.4 |
Total Medical Medicare Payment Amount |
101634.98 |
Total Medical Medicare Standardized Payment Amount |
112810.71 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
194 |
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 |
347 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2002 |