National Provider Identifier [NPI]: |
1548441009 |
Last Name Of The Provider |
WILLIAMS |
First Name Of The Provider |
KRISTOPHER |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9430 PARK WEST BLVD |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379234200 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
292 |
Number Of Medicare Beneficiaries |
161 |
Total Submitted Charge Amount |
171804 |
Total Medicare Allowed Amount |
37990.91 |
Total Medicare Payment Amount |
29070.66 |
Total Medicare Standardized Payment Amount |
31013.06 |
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 |
52 |
Number Of Medical Services |
292 |
Number Of Medicare Beneficiaries With Medical Services |
161 |
Total Medical Submitted Charge Amount |
171804 |
Total Medical Medicare Allowed Amount |
37990.91 |
Total Medical Medicare Payment Amount |
29070.66 |
Total Medical Medicare Standardized Payment Amount |
31013.06 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
85 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
146 |
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 |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6343 |