National Provider Identifier [NPI]: |
1043284391 |
Last Name Of The Provider |
RILEY |
First Name Of The Provider |
PHILLIP |
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 |
325 N STATE OF FRANKLIN RD |
Street Address 2 Of The Provider |
THIRD FLOOR |
City Of The Provider |
JOHNSON CITY |
Zip Code Of The Provider |
376046062 |
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 |
51 |
Number Of Services |
2247 |
Number Of Medicare Beneficiaries |
569 |
Total Submitted Charge Amount |
315354 |
Total Medicare Allowed Amount |
153873.31 |
Total Medicare Payment Amount |
111222.38 |
Total Medicare Standardized Payment Amount |
121478.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
92 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
423 |
Total Drug Medicare AllowedAmount |
103.01 |
Total Drug Medicare PaymentAmount |
71.93 |
Total Drug Medicare Standardized Payment Amount |
71.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
2155 |
Number Of Medicare Beneficiaries With Medical Services |
569 |
Total Medical Submitted Charge Amount |
314931 |
Total Medical Medicare Allowed Amount |
153770.3 |
Total Medical Medicare Payment Amount |
111150.45 |
Total Medical Medicare Standardized Payment Amount |
121406.66 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
186 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
548 |
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 |
463 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9123 |