National Provider Identifier [NPI]: |
1417995564 |
Last Name Of The Provider |
TSAI |
First Name Of The Provider |
EUGENE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2200 RANDALLIA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468054638 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
182 |
Number Of Services |
4060 |
Number Of Medicare Beneficiaries |
2906 |
Total Submitted Charge Amount |
381639 |
Total Medicare Allowed Amount |
108904.22 |
Total Medicare Payment Amount |
82046.22 |
Total Medicare Standardized Payment Amount |
86095.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
182 |
Number Of Medical Services |
4060 |
Number Of Medicare Beneficiaries With Medical Services |
2906 |
Total Medical Submitted Charge Amount |
381639 |
Total Medical Medicare Allowed Amount |
108904.22 |
Total Medical Medicare Payment Amount |
82046.22 |
Total Medical Medicare Standardized Payment Amount |
86095.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
573 |
Number Of Beneficiaries Age 65 to 74 |
1073 |
Number Of Beneficiaries Age 75 to 84 |
799 |
Number Of Beneficiaries Age Greater 84 |
461 |
Number Of Female Beneficiaries |
1883 |
Number Of Male Beneficiaries |
1023 |
Number Of Non Hispanic White Beneficiaries |
2755 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2190 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
716 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3895 |