National Provider Identifier [NPI]: |
1841234432 |
Last Name Of The Provider |
HARRIS |
First Name Of The Provider |
TROY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
651 DUNLOP LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
CLARKSVILLE |
Zip Code Of The Provider |
370405015 |
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 |
23 |
Number Of Services |
828 |
Number Of Medicare Beneficiaries |
659 |
Total Submitted Charge Amount |
817073 |
Total Medicare Allowed Amount |
105688.77 |
Total Medicare Payment Amount |
81609.34 |
Total Medicare Standardized Payment Amount |
86138.53 |
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 |
23 |
Number Of Medical Services |
828 |
Number Of Medicare Beneficiaries With Medical Services |
659 |
Total Medical Submitted Charge Amount |
817073 |
Total Medical Medicare Allowed Amount |
105688.77 |
Total Medical Medicare Payment Amount |
81609.34 |
Total Medical Medicare Standardized Payment Amount |
86138.53 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
191 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
379 |
Number Of Male Beneficiaries |
280 |
Number Of Non Hispanic White Beneficiaries |
491 |
Number Of Black or African American Beneficiaries |
133 |
Number Of AsianPacific Islander Beneficiaries |
13 |
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 |
462 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9269 |