National Provider Identifier [NPI]: |
1417277435 |
Last Name Of The Provider |
TYO |
First Name Of The Provider |
STEPHANIE |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
112 N LEE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
GLADEWATER |
Zip Code Of The Provider |
756472509 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
5078 |
Number Of Medicare Beneficiaries |
250 |
Total Submitted Charge Amount |
155904.32 |
Total Medicare Allowed Amount |
87477.83 |
Total Medicare Payment Amount |
61260.35 |
Total Medicare Standardized Payment Amount |
64498.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
3745 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
37939.32 |
Total Drug Medicare AllowedAmount |
13995.24 |
Total Drug Medicare PaymentAmount |
10954.85 |
Total Drug Medicare Standardized Payment Amount |
10954.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
1333 |
Number Of Medicare Beneficiaries With Medical Services |
250 |
Total Medical Submitted Charge Amount |
117965 |
Total Medical Medicare Allowed Amount |
73482.59 |
Total Medical Medicare Payment Amount |
50305.5 |
Total Medical Medicare Standardized Payment Amount |
53543.61 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
84 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
199 |
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 |
146 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1809 |