National Provider Identifier [NPI]: |
1467415067 |
Last Name Of The Provider |
JARVIS |
First Name Of The Provider |
STUART |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1706 E LAMAR ALEXANDER PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARYVILLE |
Zip Code Of The Provider |
378046204 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1041 |
Number Of Medicare Beneficiaries |
440 |
Total Submitted Charge Amount |
580430 |
Total Medicare Allowed Amount |
124842.56 |
Total Medicare Payment Amount |
96387.42 |
Total Medicare Standardized Payment Amount |
105224.54 |
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 |
31 |
Number Of Medical Services |
1041 |
Number Of Medicare Beneficiaries With Medical Services |
440 |
Total Medical Submitted Charge Amount |
580430 |
Total Medical Medicare Allowed Amount |
124842.56 |
Total Medical Medicare Payment Amount |
96387.42 |
Total Medical Medicare Standardized Payment Amount |
105224.54 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
220 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
224 |
Number Of Male Beneficiaries |
216 |
Number Of Non Hispanic White Beneficiaries |
425 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
375 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.2076 |