National Provider Identifier [NPI]: |
1801831789 |
Last Name Of The Provider |
TINLEY |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
950 W MAGNOLIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
76104 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
804 |
Number Of Medicare Beneficiaries |
177 |
Total Submitted Charge Amount |
41731.07 |
Total Medicare Allowed Amount |
31859.78 |
Total Medicare Payment Amount |
23298.96 |
Total Medicare Standardized Payment Amount |
28573.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
27 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
81 |
Total Drug Medicare AllowedAmount |
48.26 |
Total Drug Medicare PaymentAmount |
31.05 |
Total Drug Medicare Standardized Payment Amount |
31.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
777 |
Number Of Medicare Beneficiaries With Medical Services |
177 |
Total Medical Submitted Charge Amount |
41650.07 |
Total Medical Medicare Allowed Amount |
31811.52 |
Total Medical Medicare Payment Amount |
23267.91 |
Total Medical Medicare Standardized Payment Amount |
28542.03 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
17 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
79 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1666 |