National Provider Identifier [NPI]: |
1144266768 |
Last Name Of The Provider |
AUSTIN |
First Name Of The Provider |
MAYNARD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1404 TUSCULUM BLVD |
Street Address 2 Of The Provider |
LAUGHLIN MOB, SUITE 3100 |
City Of The Provider |
GREENEVILLE |
Zip Code Of The Provider |
377454395 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
100 |
Number Of Services |
9135 |
Number Of Medicare Beneficiaries |
2108 |
Total Submitted Charge Amount |
509714 |
Total Medicare Allowed Amount |
212599.68 |
Total Medicare Payment Amount |
159933.5 |
Total Medicare Standardized Payment Amount |
168194.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
288 |
Number Of Medicare Beneficiaries With Drug Services |
150 |
Total Drug Submitted ChargeAmount |
4190 |
Total Drug Medicare AllowedAmount |
3415.28 |
Total Drug Medicare PaymentAmount |
3319.35 |
Total Drug Medicare Standardized Payment Amount |
3319.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
94 |
Number Of Medical Services |
8847 |
Number Of Medicare Beneficiaries With Medical Services |
2108 |
Total Medical Submitted Charge Amount |
505524 |
Total Medical Medicare Allowed Amount |
209184.4 |
Total Medical Medicare Payment Amount |
156614.15 |
Total Medical Medicare Standardized Payment Amount |
164875.39 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
349 |
Number Of Beneficiaries Age 65 to 74 |
707 |
Number Of Beneficiaries Age 75 to 84 |
710 |
Number Of Beneficiaries Age Greater 84 |
342 |
Number Of Female Beneficiaries |
1202 |
Number Of Male Beneficiaries |
906 |
Number Of Non Hispanic White Beneficiaries |
2070 |
Number Of Black or African American Beneficiaries |
22 |
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 |
1562 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
546 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3923 |