National Provider Identifier [NPI]: |
1972699494 |
Last Name Of The Provider |
HAYDEN |
First Name Of The Provider |
TIM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
31 HUGHES DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
38305 |
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 |
90 |
Number Of Services |
11383 |
Number Of Medicare Beneficiaries |
615 |
Total Submitted Charge Amount |
598758 |
Total Medicare Allowed Amount |
271375.01 |
Total Medicare Payment Amount |
197592.78 |
Total Medicare Standardized Payment Amount |
210768.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
17 |
Number Of Drug Services |
2747 |
Number Of Medicare Beneficiaries With Drug Services |
326 |
Total Drug Submitted ChargeAmount |
47088 |
Total Drug Medicare AllowedAmount |
28281.48 |
Total Drug Medicare PaymentAmount |
24276.12 |
Total Drug Medicare Standardized Payment Amount |
24276.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
8636 |
Number Of Medicare Beneficiaries With Medical Services |
614 |
Total Medical Submitted Charge Amount |
551670 |
Total Medical Medicare Allowed Amount |
243093.53 |
Total Medical Medicare Payment Amount |
173316.66 |
Total Medical Medicare Standardized Payment Amount |
186492.33 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
331 |
Number Of Beneficiaries Age 75 to 84 |
146 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
325 |
Number Of Male Beneficiaries |
290 |
Number Of Non Hispanic White Beneficiaries |
565 |
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 |
542 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
2 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.904 |