National Provider Identifier [NPI]: |
1255333233 |
Last Name Of The Provider |
MCCOMB |
First Name Of The Provider |
RANDY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1265 UNION AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381043415 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1004 |
Number Of Medicare Beneficiaries |
885 |
Total Submitted Charge Amount |
1250471 |
Total Medicare Allowed Amount |
136980.89 |
Total Medicare Payment Amount |
104276.36 |
Total Medicare Standardized Payment Amount |
111540.86 |
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 |
18 |
Number Of Medical Services |
1004 |
Number Of Medicare Beneficiaries With Medical Services |
885 |
Total Medical Submitted Charge Amount |
1250471 |
Total Medical Medicare Allowed Amount |
136980.89 |
Total Medical Medicare Payment Amount |
104276.36 |
Total Medical Medicare Standardized Payment Amount |
111540.86 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
284 |
Number Of Beneficiaries Age 65 to 74 |
266 |
Number Of Beneficiaries Age 75 to 84 |
208 |
Number Of Beneficiaries Age Greater 84 |
127 |
Number Of Female Beneficiaries |
515 |
Number Of Male Beneficiaries |
370 |
Number Of Non Hispanic White Beneficiaries |
803 |
Number Of Black or African American Beneficiaries |
61 |
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 |
455 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
430 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.871 |