National Provider Identifier [NPI]: |
1528037660 |
Last Name Of The Provider |
BRYANT |
First Name Of The Provider |
ERIN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2811 W MARKET ST |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376045127 |
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 |
40 |
Number Of Services |
1222 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
86363 |
Total Medicare Allowed Amount |
64383.37 |
Total Medicare Payment Amount |
44112.69 |
Total Medicare Standardized Payment Amount |
48927.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
211 |
Number Of Medicare Beneficiaries With Drug Services |
93 |
Total Drug Submitted ChargeAmount |
3036 |
Total Drug Medicare AllowedAmount |
2404.02 |
Total Drug Medicare PaymentAmount |
2121.74 |
Total Drug Medicare Standardized Payment Amount |
2121.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
1011 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
83327 |
Total Medical Medicare Allowed Amount |
61979.35 |
Total Medical Medicare Payment Amount |
41990.95 |
Total Medical Medicare Standardized Payment Amount |
46805.27 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
206 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
123 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1764 |