National Provider Identifier [NPI]: |
1639116460 |
Last Name Of The Provider |
SAGADRACA |
First Name Of The Provider |
REMY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 TAKOMA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENEVILLE |
Zip Code Of The Provider |
377434647 |
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 |
24 |
Number Of Services |
504 |
Number Of Medicare Beneficiaries |
406 |
Total Submitted Charge Amount |
360260 |
Total Medicare Allowed Amount |
58245.12 |
Total Medicare Payment Amount |
44645.43 |
Total Medicare Standardized Payment Amount |
47022.98 |
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 |
24 |
Number Of Medical Services |
504 |
Number Of Medicare Beneficiaries With Medical Services |
406 |
Total Medical Submitted Charge Amount |
360260 |
Total Medical Medicare Allowed Amount |
58245.12 |
Total Medical Medicare Payment Amount |
44645.43 |
Total Medical Medicare Standardized Payment Amount |
47022.98 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
162 |
Number Of Non Hispanic White Beneficiaries |
390 |
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
225 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6477 |