National Provider Identifier [NPI]: |
1114906112 |
Last Name Of The Provider |
WEST |
First Name Of The Provider |
GILBERT |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PH.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
143 COLLEGE ST |
Street Address 2 Of The Provider |
SUITE 2 |
City Of The Provider |
MONTEAGLE |
Zip Code Of The Provider |
373567004 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
268 |
Number Of Medicare Beneficiaries |
169 |
Total Submitted Charge Amount |
37725 |
Total Medicare Allowed Amount |
28799.57 |
Total Medicare Payment Amount |
21569.97 |
Total Medicare Standardized Payment Amount |
22297.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
5 |
Number Of Medical Services |
268 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
37725 |
Total Medical Medicare Allowed Amount |
28799.57 |
Total Medical Medicare Payment Amount |
21569.97 |
Total Medical Medicare Standardized Payment Amount |
22297.11 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
151 |
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 |
26 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
58 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
46 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.3391 |