National Provider Identifier [NPI]: |
1679566962 |
Last Name Of The Provider |
ALISON |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
325 N STATE OF FRANKLIN RD |
Street Address 2 Of The Provider |
3RD FLOOR |
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376046062 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1031 |
Number Of Medicare Beneficiaries |
495 |
Total Submitted Charge Amount |
286832 |
Total Medicare Allowed Amount |
121818.26 |
Total Medicare Payment Amount |
87373.59 |
Total Medicare Standardized Payment Amount |
95238.21 |
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 |
41 |
Number Of Medical Services |
1031 |
Number Of Medicare Beneficiaries With Medical Services |
495 |
Total Medical Submitted Charge Amount |
286832 |
Total Medical Medicare Allowed Amount |
121818.26 |
Total Medical Medicare Payment Amount |
87373.59 |
Total Medical Medicare Standardized Payment Amount |
95238.21 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
223 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
186 |
Number Of Non Hispanic White Beneficiaries |
474 |
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 |
380 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2208 |