National Provider Identifier [NPI]: |
1558368837 |
Last Name Of The Provider |
POOLE |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
251 N LYERLY ST |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374042739 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
22798 |
Number Of Medicare Beneficiaries |
1285 |
Total Submitted Charge Amount |
1175906.44 |
Total Medicare Allowed Amount |
581466.99 |
Total Medicare Payment Amount |
455685.75 |
Total Medicare Standardized Payment Amount |
481526.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
13483 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
70715 |
Total Drug Medicare AllowedAmount |
40683.1 |
Total Drug Medicare PaymentAmount |
31158.27 |
Total Drug Medicare Standardized Payment Amount |
31158.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
9315 |
Number Of Medicare Beneficiaries With Medical Services |
1285 |
Total Medical Submitted Charge Amount |
1105191.44 |
Total Medical Medicare Allowed Amount |
540783.89 |
Total Medical Medicare Payment Amount |
424527.48 |
Total Medical Medicare Standardized Payment Amount |
450368.71 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
341 |
Number Of Beneficiaries Age 65 to 74 |
434 |
Number Of Beneficiaries Age 75 to 84 |
366 |
Number Of Beneficiaries Age Greater 84 |
144 |
Number Of Female Beneficiaries |
628 |
Number Of Male Beneficiaries |
657 |
Number Of Non Hispanic White Beneficiaries |
1015 |
Number Of Black or African American Beneficiaries |
245 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
855 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
430 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.2509 |