National Provider Identifier [NPI]: |
1336146315 |
Last Name Of The Provider |
MCKENZIE |
First Name Of The Provider |
ANTRONETTE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
75 PHYSICIANS LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTHAVEN |
Zip Code Of The Provider |
386716102 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
80 |
Number Of Services |
3327 |
Number Of Medicare Beneficiaries |
368 |
Total Submitted Charge Amount |
191387 |
Total Medicare Allowed Amount |
97573.75 |
Total Medicare Payment Amount |
68519.29 |
Total Medicare Standardized Payment Amount |
74780.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
109 |
Number Of Medicare Beneficiaries With Drug Services |
77 |
Total Drug Submitted ChargeAmount |
2342 |
Total Drug Medicare AllowedAmount |
1488.88 |
Total Drug Medicare PaymentAmount |
1374.56 |
Total Drug Medicare Standardized Payment Amount |
1374.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
3218 |
Number Of Medicare Beneficiaries With Medical Services |
368 |
Total Medical Submitted Charge Amount |
189045 |
Total Medical Medicare Allowed Amount |
96084.87 |
Total Medical Medicare Payment Amount |
67144.73 |
Total Medical Medicare Standardized Payment Amount |
73406.18 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
276 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
231 |
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 |
329 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0463 |