National Provider Identifier [NPI]: |
1225180086 |
Last Name Of The Provider |
BUNN |
First Name Of The Provider |
EMILY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3500 N MOUNT JULIET RD |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
MOUNT JULIET |
Zip Code Of The Provider |
371223059 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
103 |
Number Of Medicare Beneficiaries |
36 |
Total Submitted Charge Amount |
8069.78 |
Total Medicare Allowed Amount |
2804.01 |
Total Medicare Payment Amount |
1604.2 |
Total Medicare Standardized Payment Amount |
2295.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
34 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
979.1 |
Total Drug Medicare AllowedAmount |
89.09 |
Total Drug Medicare PaymentAmount |
60.68 |
Total Drug Medicare Standardized Payment Amount |
60.68 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
69 |
Number Of Medicare Beneficiaries With Medical Services |
36 |
Total Medical Submitted Charge Amount |
7090.68 |
Total Medical Medicare Allowed Amount |
2714.92 |
Total Medical Medicare Payment Amount |
1543.52 |
Total Medical Medicare Standardized Payment Amount |
2234.47 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
18 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
23 |
Number Of Male Beneficiaries |
13 |
Number Of Non Hispanic White Beneficiaries |
36 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.9534 |