National Provider Identifier [NPI]: |
1275518003 |
Last Name Of The Provider |
KEMP |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
632 MORRISON SPRINGS RD |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374153416 |
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 |
98 |
Number Of Services |
5523 |
Number Of Medicare Beneficiaries |
307 |
Total Submitted Charge Amount |
408317 |
Total Medicare Allowed Amount |
163937.88 |
Total Medicare Payment Amount |
116265.61 |
Total Medicare Standardized Payment Amount |
126496.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
615 |
Number Of Medicare Beneficiaries With Drug Services |
196 |
Total Drug Submitted ChargeAmount |
14996 |
Total Drug Medicare AllowedAmount |
4114.68 |
Total Drug Medicare PaymentAmount |
3661.71 |
Total Drug Medicare Standardized Payment Amount |
3661.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
4908 |
Number Of Medicare Beneficiaries With Medical Services |
307 |
Total Medical Submitted Charge Amount |
393321 |
Total Medical Medicare Allowed Amount |
159823.2 |
Total Medical Medicare Payment Amount |
112603.9 |
Total Medical Medicare Standardized Payment Amount |
122834.32 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
134 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
296 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8874 |