National Provider Identifier [NPI]: |
1780938522 |
Last Name Of The Provider |
MORGAN |
First Name Of The Provider |
KYLE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3 PROFESSIONAL PARK DR |
Street Address 2 Of The Provider |
SUITE 21 |
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376046529 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Multispecialty Clinic/Group Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
101 |
Number Of Services |
793 |
Number Of Medicare Beneficiaries |
306 |
Total Submitted Charge Amount |
194802 |
Total Medicare Allowed Amount |
48463.52 |
Total Medicare Payment Amount |
35939.57 |
Total Medicare Standardized Payment Amount |
44448.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
120 |
Number Of Medicare Beneficiaries With Drug Services |
73 |
Total Drug Submitted ChargeAmount |
12565 |
Total Drug Medicare AllowedAmount |
7345.07 |
Total Drug Medicare PaymentAmount |
5712.09 |
Total Drug Medicare Standardized Payment Amount |
5712.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
96 |
Number Of Medical Services |
673 |
Number Of Medicare Beneficiaries With Medical Services |
306 |
Total Medical Submitted Charge Amount |
182237 |
Total Medical Medicare Allowed Amount |
41118.45 |
Total Medical Medicare Payment Amount |
30227.48 |
Total Medical Medicare Standardized Payment Amount |
38736.66 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
226 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3209 |