National Provider Identifier [NPI]: |
1134490527 |
Last Name Of The Provider |
FREEMAN |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 MAIN ST UNIT 6 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LOUDON |
Zip Code Of The Provider |
377741602 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
387 |
Number Of Medicare Beneficiaries |
364 |
Total Submitted Charge Amount |
225760 |
Total Medicare Allowed Amount |
54621.13 |
Total Medicare Payment Amount |
42327.83 |
Total Medicare Standardized Payment Amount |
44872.34 |
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 |
3 |
Number Of Medical Services |
387 |
Number Of Medicare Beneficiaries With Medical Services |
364 |
Total Medical Submitted Charge Amount |
225760 |
Total Medical Medicare Allowed Amount |
54621.13 |
Total Medical Medicare Payment Amount |
42327.83 |
Total Medical Medicare Standardized Payment Amount |
44872.34 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
169 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
167 |
Number Of Non Hispanic White Beneficiaries |
348 |
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 |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.057 |