National Provider Identifier [NPI]: |
1154324960 |
Last Name Of The Provider |
BRYANT |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
205 HOSPITAL DR |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
MC KENZIE |
Zip Code Of The Provider |
382011649 |
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 |
216 |
Number Of Services |
12539.5 |
Number Of Medicare Beneficiaries |
611 |
Total Submitted Charge Amount |
994558 |
Total Medicare Allowed Amount |
413581.51 |
Total Medicare Payment Amount |
330231.29 |
Total Medicare Standardized Payment Amount |
342973.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
22 |
Number Of Drug Services |
2618.5 |
Number Of Medicare Beneficiaries With Drug Services |
154 |
Total Drug Submitted ChargeAmount |
31530 |
Total Drug Medicare AllowedAmount |
14032.89 |
Total Drug Medicare PaymentAmount |
11346.7 |
Total Drug Medicare Standardized Payment Amount |
11346.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
194 |
Number Of Medical Services |
9921 |
Number Of Medicare Beneficiaries With Medical Services |
611 |
Total Medical Submitted Charge Amount |
963028 |
Total Medical Medicare Allowed Amount |
399548.62 |
Total Medical Medicare Payment Amount |
318884.59 |
Total Medical Medicare Standardized Payment Amount |
331626.33 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
241 |
Number Of Beneficiaries Age 65 to 74 |
218 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
279 |
Number Of Non Hispanic White Beneficiaries |
547 |
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 |
350 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
261 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.437 |