National Provider Identifier [NPI]: |
1104811249 |
Last Name Of The Provider |
BANKS |
First Name Of The Provider |
MARSHALL |
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 |
700 W FOREST AVE |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383013937 |
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 |
146 |
Number Of Services |
8608 |
Number Of Medicare Beneficiaries |
726 |
Total Submitted Charge Amount |
387755 |
Total Medicare Allowed Amount |
172536.97 |
Total Medicare Payment Amount |
128588.41 |
Total Medicare Standardized Payment Amount |
137594.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
25 |
Number Of Drug Services |
2630 |
Number Of Medicare Beneficiaries With Drug Services |
217 |
Total Drug Submitted ChargeAmount |
12194 |
Total Drug Medicare AllowedAmount |
5770.46 |
Total Drug Medicare PaymentAmount |
5352.45 |
Total Drug Medicare Standardized Payment Amount |
5352.45 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
121 |
Number Of Medical Services |
5978 |
Number Of Medicare Beneficiaries With Medical Services |
726 |
Total Medical Submitted Charge Amount |
375561 |
Total Medical Medicare Allowed Amount |
166766.51 |
Total Medical Medicare Payment Amount |
123235.96 |
Total Medical Medicare Standardized Payment Amount |
132242.21 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
277 |
Number Of Beneficiaries Age 75 to 84 |
224 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
407 |
Number Of Male Beneficiaries |
319 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
384 |
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 |
528 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6312 |