National Provider Identifier [NPI]: |
1467452425 |
Last Name Of The Provider |
MICHAELIS |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2525 DESALES AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374041161 |
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 |
19 |
Number Of Services |
1452 |
Number Of Medicare Beneficiaries |
569 |
Total Submitted Charge Amount |
328817 |
Total Medicare Allowed Amount |
133270.1 |
Total Medicare Payment Amount |
101352.13 |
Total Medicare Standardized Payment Amount |
106659.27 |
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 |
19 |
Number Of Medical Services |
1452 |
Number Of Medicare Beneficiaries With Medical Services |
569 |
Total Medical Submitted Charge Amount |
328817 |
Total Medical Medicare Allowed Amount |
133270.1 |
Total Medical Medicare Payment Amount |
101352.13 |
Total Medical Medicare Standardized Payment Amount |
106659.27 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
198 |
Number Of Beneficiaries Age Greater 84 |
134 |
Number Of Female Beneficiaries |
324 |
Number Of Male Beneficiaries |
245 |
Number Of Non Hispanic White Beneficiaries |
433 |
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 |
436 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.3858 |