National Provider Identifier [NPI]: |
1730197351 |
Last Name Of The Provider |
BOLT |
First Name Of The Provider |
PATRICK |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1819 W CLINCH AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379162434 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
97 |
Number Of Services |
1492 |
Number Of Medicare Beneficiaries |
349 |
Total Submitted Charge Amount |
1117988 |
Total Medicare Allowed Amount |
175243.21 |
Total Medicare Payment Amount |
131928.78 |
Total Medicare Standardized Payment Amount |
142087.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
47 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
376 |
Total Drug Medicare AllowedAmount |
268.18 |
Total Drug Medicare PaymentAmount |
210.22 |
Total Drug Medicare Standardized Payment Amount |
210.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
96 |
Number Of Medical Services |
1445 |
Number Of Medicare Beneficiaries With Medical Services |
349 |
Total Medical Submitted Charge Amount |
1117612 |
Total Medical Medicare Allowed Amount |
174975.03 |
Total Medical Medicare Payment Amount |
131718.56 |
Total Medical Medicare Standardized Payment Amount |
141877.5 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
329 |
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 |
295 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1733 |