| National Provider Identifier [NPI]: | 1669420972 |
| Last Name Of The Provider | SOLOMON |
| First Name Of The Provider | MARIANNE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9330 PARK WEST BLVD |
| Street Address 2 Of The Provider | SUITE 402 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379234308 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 486 |
| Number Of Medicare Beneficiaries | 24 |
| Total Submitted Charge Amount | 19450.83 |
| Total Medicare Allowed Amount | 11931.13 |
| Total Medicare Payment Amount | 9940.2 |
| Total Medicare Standardized Payment Amount | 10504.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 842 |
| Total Drug Medicare AllowedAmount | 707.24 |
| Total Drug Medicare PaymentAmount | 692.83 |
| Total Drug Medicare Standardized Payment Amount | 692.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 465 |
| Number Of Medicare Beneficiaries With Medical Services | 24 |
| Total Medical Submitted Charge Amount | 18608.83 |
| Total Medical Medicare Allowed Amount | 11223.89 |
| Total Medical Medicare Payment Amount | 9247.37 |
| Total Medical Medicare Standardized Payment Amount | 9811.81 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.6758 |