National Provider Identifier [NPI]: |
1871548818 |
Last Name Of The Provider |
KLEIN |
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 |
4220 HARDING RD |
Street Address 2 Of The Provider |
ST THOMAS HOSPITAL |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
37205 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
176 |
Number Of Services |
6603 |
Number Of Medicare Beneficiaries |
4360 |
Total Submitted Charge Amount |
601905.5 |
Total Medicare Allowed Amount |
191564.1 |
Total Medicare Payment Amount |
147428.48 |
Total Medicare Standardized Payment Amount |
157904.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
684 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
3420 |
Total Drug Medicare AllowedAmount |
1346.32 |
Total Drug Medicare PaymentAmount |
1044.42 |
Total Drug Medicare Standardized Payment Amount |
1044.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
175 |
Number Of Medical Services |
5919 |
Number Of Medicare Beneficiaries With Medical Services |
4360 |
Total Medical Submitted Charge Amount |
598485.5 |
Total Medical Medicare Allowed Amount |
190217.78 |
Total Medical Medicare Payment Amount |
146384.06 |
Total Medical Medicare Standardized Payment Amount |
156859.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
931 |
Number Of Beneficiaries Age 65 to 74 |
1526 |
Number Of Beneficiaries Age 75 to 84 |
1234 |
Number Of Beneficiaries Age Greater 84 |
669 |
Number Of Female Beneficiaries |
2527 |
Number Of Male Beneficiaries |
1833 |
Number Of Non Hispanic White Beneficiaries |
3811 |
Number Of Black or African American Beneficiaries |
444 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
46 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
30 |
Number Of Beneficiaries With Medicare Only Entitlement |
3193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1167 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8995 |