National Provider Identifier [NPI]: |
1043299878 |
Last Name Of The Provider |
BELL |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1948 N JACKSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULLAHOMA |
Zip Code Of The Provider |
373882204 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
1376 |
Number Of Medicare Beneficiaries |
323 |
Total Submitted Charge Amount |
209799 |
Total Medicare Allowed Amount |
110606.82 |
Total Medicare Payment Amount |
80120.05 |
Total Medicare Standardized Payment Amount |
88563.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
24 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
240 |
Total Drug Medicare AllowedAmount |
70.11 |
Total Drug Medicare PaymentAmount |
54.97 |
Total Drug Medicare Standardized Payment Amount |
54.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1352 |
Number Of Medicare Beneficiaries With Medical Services |
323 |
Total Medical Submitted Charge Amount |
209559 |
Total Medical Medicare Allowed Amount |
110536.71 |
Total Medical Medicare Payment Amount |
80065.08 |
Total Medical Medicare Standardized Payment Amount |
88508.89 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
155 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
211 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
307 |
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 |
285 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1778 |