National Provider Identifier [NPI]: |
1639116999 |
Last Name Of The Provider |
KAROLCZAK |
First Name Of The Provider |
PAWEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
907 E LAMAR ALEXANDER PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARYVILLE |
Zip Code Of The Provider |
378045015 |
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 |
1529 |
Number Of Medicare Beneficiaries |
475 |
Total Submitted Charge Amount |
456789 |
Total Medicare Allowed Amount |
135058.26 |
Total Medicare Payment Amount |
105222.49 |
Total Medicare Standardized Payment Amount |
111006.17 |
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 |
1529 |
Number Of Medicare Beneficiaries With Medical Services |
475 |
Total Medical Submitted Charge Amount |
456789 |
Total Medical Medicare Allowed Amount |
135058.26 |
Total Medical Medicare Payment Amount |
105222.49 |
Total Medical Medicare Standardized Payment Amount |
111006.17 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
263 |
Number Of Male Beneficiaries |
212 |
Number Of Non Hispanic White Beneficiaries |
436 |
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 |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
200 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.4915 |