National Provider Identifier [NPI]: |
1689814899 |
Last Name Of The Provider |
CARR |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7565 DANNAHER WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
POWELL |
Zip Code Of The Provider |
378494029 |
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 |
26 |
Number Of Services |
407 |
Number Of Medicare Beneficiaries |
321 |
Total Submitted Charge Amount |
271976 |
Total Medicare Allowed Amount |
35046.44 |
Total Medicare Payment Amount |
26936.18 |
Total Medicare Standardized Payment Amount |
33584.08 |
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 |
26 |
Number Of Medical Services |
407 |
Number Of Medicare Beneficiaries With Medical Services |
321 |
Total Medical Submitted Charge Amount |
271976 |
Total Medical Medicare Allowed Amount |
35046.44 |
Total Medical Medicare Payment Amount |
26936.18 |
Total Medical Medicare Standardized Payment Amount |
33584.08 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
142 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
60 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
129 |
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 |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.202 |