National Provider Identifier [NPI]: |
1861495152 |
Last Name Of The Provider |
POMPHREY |
First Name Of The Provider |
ROBERT |
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 |
205 HOSPITAL DR |
Street Address 2 Of The Provider |
STE A |
City Of The Provider |
MC KENZIE |
Zip Code Of The Provider |
382011649 |
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 |
166 |
Number Of Services |
4521 |
Number Of Medicare Beneficiaries |
567 |
Total Submitted Charge Amount |
640170 |
Total Medicare Allowed Amount |
225713.68 |
Total Medicare Payment Amount |
174944.77 |
Total Medicare Standardized Payment Amount |
184651.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
22 |
Number Of Drug Services |
797 |
Number Of Medicare Beneficiaries With Drug Services |
94 |
Total Drug Submitted ChargeAmount |
13622 |
Total Drug Medicare AllowedAmount |
1706.08 |
Total Drug Medicare PaymentAmount |
1413.9 |
Total Drug Medicare Standardized Payment Amount |
1413.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
144 |
Number Of Medical Services |
3724 |
Number Of Medicare Beneficiaries With Medical Services |
567 |
Total Medical Submitted Charge Amount |
626548 |
Total Medical Medicare Allowed Amount |
224007.6 |
Total Medical Medicare Payment Amount |
173530.87 |
Total Medical Medicare Standardized Payment Amount |
183237.43 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
195 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
137 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
353 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
519 |
Number Of Black or African American Beneficiaries |
37 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
288 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
51 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6809 |