National Provider Identifier [NPI]: |
1730265901 |
Last Name Of The Provider |
EMBREE |
First Name Of The Provider |
STANLEY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
353 NEW SHACKLE ISLAND RD STE 203A |
Street Address 2 Of The Provider |
|
City Of The Provider |
HENDERSONVILLE |
Zip Code Of The Provider |
370752371 |
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 |
15 |
Number Of Services |
463 |
Number Of Medicare Beneficiaries |
234 |
Total Submitted Charge Amount |
76706 |
Total Medicare Allowed Amount |
26225.09 |
Total Medicare Payment Amount |
17751.24 |
Total Medicare Standardized Payment Amount |
19717.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
32 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
776 |
Total Drug Medicare AllowedAmount |
187.62 |
Total Drug Medicare PaymentAmount |
123.46 |
Total Drug Medicare Standardized Payment Amount |
123.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
431 |
Number Of Medicare Beneficiaries With Medical Services |
233 |
Total Medical Submitted Charge Amount |
75930 |
Total Medical Medicare Allowed Amount |
26037.47 |
Total Medical Medicare Payment Amount |
17627.78 |
Total Medical Medicare Standardized Payment Amount |
19593.56 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
217 |
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 |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4045 |