National Provider Identifier [NPI]: |
1659460699 |
Last Name Of The Provider |
BREEDEN |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 TVC |
Street Address 2 Of The Provider |
|
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372320001 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1524 |
Number Of Medicare Beneficiaries |
468 |
Total Submitted Charge Amount |
216829 |
Total Medicare Allowed Amount |
52833.75 |
Total Medicare Payment Amount |
38549.22 |
Total Medicare Standardized Payment Amount |
41413.63 |
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 |
21 |
Number Of Medical Services |
1524 |
Number Of Medicare Beneficiaries With Medical Services |
468 |
Total Medical Submitted Charge Amount |
216829 |
Total Medical Medicare Allowed Amount |
52833.75 |
Total Medical Medicare Payment Amount |
38549.22 |
Total Medical Medicare Standardized Payment Amount |
41413.63 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
129 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
233 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
342 |
Number Of Black or African American Beneficiaries |
110 |
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 |
369 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
99 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.173 |