National Provider Identifier [NPI]: |
1285889311 |
Last Name Of The Provider |
COLE |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12744 KINGSTON PIKE |
Street Address 2 Of The Provider |
STE 108 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379340940 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
3078 |
Number Of Medicare Beneficiaries |
346 |
Total Submitted Charge Amount |
1278517 |
Total Medicare Allowed Amount |
664551.43 |
Total Medicare Payment Amount |
515690.09 |
Total Medicare Standardized Payment Amount |
526519.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
1320 |
Number Of Medicare Beneficiaries With Drug Services |
88 |
Total Drug Submitted ChargeAmount |
760338 |
Total Drug Medicare AllowedAmount |
502573.93 |
Total Drug Medicare PaymentAmount |
393774.4 |
Total Drug Medicare Standardized Payment Amount |
393774.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
1758 |
Number Of Medicare Beneficiaries With Medical Services |
346 |
Total Medical Submitted Charge Amount |
518179 |
Total Medical Medicare Allowed Amount |
161977.5 |
Total Medical Medicare Payment Amount |
121915.69 |
Total Medical Medicare Standardized Payment Amount |
132744.95 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
78 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
331 |
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 |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1391 |