National Provider Identifier [NPI]: |
1396837852 |
Last Name Of The Provider |
STEWART |
First Name Of The Provider |
EARL |
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 |
2815 N HIGHLAND AVE |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383051729 |
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 |
31 |
Number Of Services |
5287 |
Number Of Medicare Beneficiaries |
361 |
Total Submitted Charge Amount |
401740 |
Total Medicare Allowed Amount |
240837.5 |
Total Medicare Payment Amount |
171371.53 |
Total Medicare Standardized Payment Amount |
199396.95 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
853 |
Number Of Medicare Beneficiaries With Drug Services |
189 |
Total Drug Submitted ChargeAmount |
41417 |
Total Drug Medicare AllowedAmount |
932.55 |
Total Drug Medicare PaymentAmount |
707.77 |
Total Drug Medicare Standardized Payment Amount |
707.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
4434 |
Number Of Medicare Beneficiaries With Medical Services |
361 |
Total Medical Submitted Charge Amount |
360323 |
Total Medical Medicare Allowed Amount |
239904.95 |
Total Medical Medicare Payment Amount |
170663.76 |
Total Medical Medicare Standardized Payment Amount |
198689.18 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
304 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.356 |