National Provider Identifier [NPI]: |
1356498224 |
Last Name Of The Provider |
FASIG |
First Name Of The Provider |
KRISTINA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5301 VIRGINIA WAY |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
BRENTWOOD |
Zip Code Of The Provider |
370277541 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
12136 |
Number Of Medicare Beneficiaries |
1276 |
Total Submitted Charge Amount |
2380914.52 |
Total Medicare Allowed Amount |
1127096.73 |
Total Medicare Payment Amount |
934664.08 |
Total Medicare Standardized Payment Amount |
698325.71 |
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 |
74 |
Number Of Medical Services |
12136 |
Number Of Medicare Beneficiaries With Medical Services |
1276 |
Total Medical Submitted Charge Amount |
2380914.52 |
Total Medical Medicare Allowed Amount |
1127096.73 |
Total Medical Medicare Payment Amount |
934664.08 |
Total Medical Medicare Standardized Payment Amount |
698325.71 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
259 |
Number Of Beneficiaries Age 65 to 74 |
550 |
Number Of Beneficiaries Age 75 to 84 |
340 |
Number Of Beneficiaries Age Greater 84 |
127 |
Number Of Female Beneficiaries |
748 |
Number Of Male Beneficiaries |
528 |
Number Of Non Hispanic White Beneficiaries |
1131 |
Number Of Black or African American Beneficiaries |
118 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
961 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
315 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5066 |