National Provider Identifier [NPI]: |
1215972591 |
Last Name Of The Provider |
HYLAND |
First Name Of The Provider |
BRYAN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6210 S BROADWAY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757034413 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
2958 |
Number Of Medicare Beneficiaries |
371 |
Total Submitted Charge Amount |
263494 |
Total Medicare Allowed Amount |
121545.3 |
Total Medicare Payment Amount |
85977.23 |
Total Medicare Standardized Payment Amount |
92405.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
283 |
Number Of Medicare Beneficiaries With Drug Services |
171 |
Total Drug Submitted ChargeAmount |
11469 |
Total Drug Medicare AllowedAmount |
5372.67 |
Total Drug Medicare PaymentAmount |
5158.96 |
Total Drug Medicare Standardized Payment Amount |
5158.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
2675 |
Number Of Medicare Beneficiaries With Medical Services |
371 |
Total Medical Submitted Charge Amount |
252025 |
Total Medical Medicare Allowed Amount |
116172.63 |
Total Medical Medicare Payment Amount |
80818.27 |
Total Medical Medicare Standardized Payment Amount |
87246.13 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
327 |
Number Of Black or African American Beneficiaries |
32 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
346 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9564 |