National Provider Identifier [NPI]: |
1609807882 |
Last Name Of The Provider |
KORN |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2525 DESALES AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
37404 |
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 |
17 |
Number Of Services |
1511 |
Number Of Medicare Beneficiaries |
1399 |
Total Submitted Charge Amount |
986610 |
Total Medicare Allowed Amount |
223398.37 |
Total Medicare Payment Amount |
166533.61 |
Total Medicare Standardized Payment Amount |
176136.46 |
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 |
17 |
Number Of Medical Services |
1511 |
Number Of Medicare Beneficiaries With Medical Services |
1399 |
Total Medical Submitted Charge Amount |
986610 |
Total Medical Medicare Allowed Amount |
223398.37 |
Total Medical Medicare Payment Amount |
166533.61 |
Total Medical Medicare Standardized Payment Amount |
176136.46 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
241 |
Number Of Beneficiaries Age 65 to 74 |
416 |
Number Of Beneficiaries Age 75 to 84 |
436 |
Number Of Beneficiaries Age Greater 84 |
306 |
Number Of Female Beneficiaries |
799 |
Number Of Male Beneficiaries |
600 |
Number Of Non Hispanic White Beneficiaries |
1186 |
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 |
1016 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
383 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.075 |