National Provider Identifier [NPI]: |
1477647220 |
Last Name Of The Provider |
THAYER |
First Name Of The Provider |
WESLEY |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
D-4207 MEDICAL CENTER NORTH |
Street Address 2 Of The Provider |
VANDERBILT MEDICAL CENTER |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372322345 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
183 |
Number Of Services |
1271 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
1253085.9 |
Total Medicare Allowed Amount |
280865.61 |
Total Medicare Payment Amount |
216509.27 |
Total Medicare Standardized Payment Amount |
235109.5 |
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 |
183 |
Number Of Medical Services |
1271 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
1253085.9 |
Total Medical Medicare Allowed Amount |
280865.61 |
Total Medical Medicare Payment Amount |
216509.27 |
Total Medical Medicare Standardized Payment Amount |
235109.5 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
118 |
Number Of Non Hispanic White Beneficiaries |
239 |
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 |
211 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.5992 |