National Provider Identifier [NPI]: |
1346401817 |
Last Name Of The Provider |
HALL |
First Name Of The Provider |
MONTE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2240 SUTHERLAND AVE |
Street Address 2 Of The Provider |
SUITE 104 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379192333 |
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 |
34 |
Number Of Services |
770 |
Number Of Medicare Beneficiaries |
521 |
Total Submitted Charge Amount |
515173 |
Total Medicare Allowed Amount |
94446.19 |
Total Medicare Payment Amount |
72199.01 |
Total Medicare Standardized Payment Amount |
75756.47 |
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 |
34 |
Number Of Medical Services |
770 |
Number Of Medicare Beneficiaries With Medical Services |
521 |
Total Medical Submitted Charge Amount |
515173 |
Total Medical Medicare Allowed Amount |
94446.19 |
Total Medical Medicare Payment Amount |
72199.01 |
Total Medical Medicare Standardized Payment Amount |
75756.47 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
503 |
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 |
285 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
236 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9732 |