National Provider Identifier [NPI]: |
1295765964 |
Last Name Of The Provider |
NOWELL |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
310 OAK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LIVINGSTON |
Zip Code Of The Provider |
385701729 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
981 |
Number Of Medicare Beneficiaries |
542 |
Total Submitted Charge Amount |
180835.3 |
Total Medicare Allowed Amount |
99678.02 |
Total Medicare Payment Amount |
72145.45 |
Total Medicare Standardized Payment Amount |
75204.14 |
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 |
26 |
Number Of Medical Services |
981 |
Number Of Medicare Beneficiaries With Medical Services |
542 |
Total Medical Submitted Charge Amount |
180835.3 |
Total Medical Medicare Allowed Amount |
99678.02 |
Total Medical Medicare Payment Amount |
72145.45 |
Total Medical Medicare Standardized Payment Amount |
75204.14 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
162 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
116 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
315 |
Number Of Male Beneficiaries |
227 |
Number Of Non Hispanic White Beneficiaries |
513 |
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 |
216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
326 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.3991 |