National Provider Identifier [NPI]: |
1316902620 |
Last Name Of The Provider |
MCQUAIN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2410 SUSANNAH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376011748 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
1274 |
Number Of Medicare Beneficiaries |
457 |
Total Submitted Charge Amount |
485545 |
Total Medicare Allowed Amount |
112521.67 |
Total Medicare Payment Amount |
79188.93 |
Total Medicare Standardized Payment Amount |
81342.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
133 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
1865 |
Total Drug Medicare AllowedAmount |
754.93 |
Total Drug Medicare PaymentAmount |
560.39 |
Total Drug Medicare Standardized Payment Amount |
560.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
1141 |
Number Of Medicare Beneficiaries With Medical Services |
457 |
Total Medical Submitted Charge Amount |
483680 |
Total Medical Medicare Allowed Amount |
111766.74 |
Total Medical Medicare Payment Amount |
78628.54 |
Total Medical Medicare Standardized Payment Amount |
80782.44 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
228 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
260 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
441 |
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 |
377 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0265 |