National Provider Identifier [NPI]: |
1679500102 |
Last Name Of The Provider |
BRUNSON |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2240 SUTHERLAND AVE |
Street Address 2 Of The Provider |
SUITE 103 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379192333 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1989 |
Number Of Medicare Beneficiaries |
538 |
Total Submitted Charge Amount |
439851 |
Total Medicare Allowed Amount |
209068.12 |
Total Medicare Payment Amount |
159485.6 |
Total Medicare Standardized Payment Amount |
169445.46 |
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 |
42 |
Number Of Medical Services |
1989 |
Number Of Medicare Beneficiaries With Medical Services |
538 |
Total Medical Submitted Charge Amount |
439851 |
Total Medical Medicare Allowed Amount |
209068.12 |
Total Medical Medicare Payment Amount |
159485.6 |
Total Medical Medicare Standardized Payment Amount |
169445.46 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
162 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
523 |
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 |
381 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
157 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
60 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0501 |