National Provider Identifier [NPI]: |
1770814766 |
Last Name Of The Provider |
SCHULTZ |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
APN |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376014877 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
18420 |
Number Of Medicare Beneficiaries |
450 |
Total Submitted Charge Amount |
1076733.18 |
Total Medicare Allowed Amount |
530651.06 |
Total Medicare Payment Amount |
494607.83 |
Total Medicare Standardized Payment Amount |
420257.63 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
53 |
Number Of Beneficiaries Age Less65 |
376 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
13 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
426 |
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 |
127 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
323 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
3 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.2732 |