National Provider Identifier [NPI]: |
1619239126 |
Last Name Of The Provider |
BAILEY |
First Name Of The Provider |
BRENDA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1540 APPLING CARE LN |
Street Address 2 Of The Provider |
STE 105 |
City Of The Provider |
CORDOVA |
Zip Code Of The Provider |
380164957 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
5720 |
Number Of Medicare Beneficiaries |
427 |
Total Submitted Charge Amount |
730767 |
Total Medicare Allowed Amount |
237652.43 |
Total Medicare Payment Amount |
189396.5 |
Total Medicare Standardized Payment Amount |
195928.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
440 |
Number Of Medicare Beneficiaries With Drug Services |
126 |
Total Drug Submitted ChargeAmount |
25470 |
Total Drug Medicare AllowedAmount |
11145.01 |
Total Drug Medicare PaymentAmount |
8723.56 |
Total Drug Medicare Standardized Payment Amount |
8723.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
5280 |
Number Of Medicare Beneficiaries With Medical Services |
427 |
Total Medical Submitted Charge Amount |
705297 |
Total Medical Medicare Allowed Amount |
226507.42 |
Total Medical Medicare Payment Amount |
180672.94 |
Total Medical Medicare Standardized Payment Amount |
187204.6 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
230 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
288 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
229 |
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 |
219 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
208 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
67 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4193 |