National Provider Identifier [NPI]: |
1568448736 |
Last Name Of The Provider |
SEELEY |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1903 OLD HICKORY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OLD HICKORY |
Zip Code Of The Provider |
371382856 |
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 |
22 |
Number Of Services |
816 |
Number Of Medicare Beneficiaries |
105 |
Total Submitted Charge Amount |
55613 |
Total Medicare Allowed Amount |
46520.67 |
Total Medicare Payment Amount |
31732.56 |
Total Medicare Standardized Payment Amount |
34395.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
1050 |
Total Drug Medicare AllowedAmount |
535.48 |
Total Drug Medicare PaymentAmount |
524.71 |
Total Drug Medicare Standardized Payment Amount |
524.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
781 |
Number Of Medicare Beneficiaries With Medical Services |
105 |
Total Medical Submitted Charge Amount |
54563 |
Total Medical Medicare Allowed Amount |
45985.19 |
Total Medical Medicare Payment Amount |
31207.85 |
Total Medical Medicare Standardized Payment Amount |
33870.33 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
29 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
93 |
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 |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.381 |