National Provider Identifier [NPI]: |
1508909599 |
Last Name Of The Provider |
KNIGHT |
First Name Of The Provider |
CECIL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D., ATC |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2003 PARKER STREET MCKENZIE ATHLETIC FACILITY |
Street Address 2 Of The Provider |
LEE UNIVERSITY BOX 3450 |
City Of The Provider |
CLEVELAND |
Zip Code Of The Provider |
373203450 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
4237 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
153816.6 |
Total Medicare Allowed Amount |
100581.16 |
Total Medicare Payment Amount |
78964.56 |
Total Medicare Standardized Payment Amount |
86136.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
167 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
2233 |
Total Drug Medicare AllowedAmount |
1068.2 |
Total Drug Medicare PaymentAmount |
1022.37 |
Total Drug Medicare Standardized Payment Amount |
1022.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
4070 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
151583.6 |
Total Medical Medicare Allowed Amount |
99512.96 |
Total Medical Medicare Payment Amount |
77942.19 |
Total Medical Medicare Standardized Payment Amount |
85113.93 |
Average Age Of Beneficiaries |
52 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
17 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
77 |
Number Of Non Hispanic White Beneficiaries |
113 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
35 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.381 |