National Provider Identifier [NPI]: |
1053411355 |
Last Name Of The Provider |
BALLARD |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
ACNP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10810 PARKSIDE DR |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379341979 |
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 |
31 |
Number Of Services |
1608 |
Number Of Medicare Beneficiaries |
468 |
Total Submitted Charge Amount |
332123 |
Total Medicare Allowed Amount |
94579.67 |
Total Medicare Payment Amount |
67712.08 |
Total Medicare Standardized Payment Amount |
87224.65 |
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 |
31 |
Number Of Medical Services |
1608 |
Number Of Medicare Beneficiaries With Medical Services |
468 |
Total Medical Submitted Charge Amount |
332123 |
Total Medical Medicare Allowed Amount |
94579.67 |
Total Medical Medicare Payment Amount |
67712.08 |
Total Medical Medicare Standardized Payment Amount |
87224.65 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
199 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
59 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
254 |
Number Of Non Hispanic White Beneficiaries |
450 |
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 |
359 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5268 |