National Provider Identifier [NPI]: |
1992818421 |
Last Name Of The Provider |
EVANS |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4735 OGLETOWN STANTON RD |
Street Address 2 Of The Provider |
MEDICAL ARTS PAVILION 2 SUITE 1208 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197132072 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
110 |
Number Of Services |
2981 |
Number Of Medicare Beneficiaries |
1025 |
Total Submitted Charge Amount |
1535359.65 |
Total Medicare Allowed Amount |
525916.03 |
Total Medicare Payment Amount |
396884.81 |
Total Medicare Standardized Payment Amount |
395743.51 |
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 |
110 |
Number Of Medical Services |
2981 |
Number Of Medicare Beneficiaries With Medical Services |
1025 |
Total Medical Submitted Charge Amount |
1535359.65 |
Total Medical Medicare Allowed Amount |
525916.03 |
Total Medical Medicare Payment Amount |
396884.81 |
Total Medical Medicare Standardized Payment Amount |
395743.51 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
206 |
Number Of Beneficiaries Age 65 to 74 |
324 |
Number Of Beneficiaries Age 75 to 84 |
337 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
474 |
Number Of Male Beneficiaries |
551 |
Number Of Non Hispanic White Beneficiaries |
716 |
Number Of Black or African American Beneficiaries |
256 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
787 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
238 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
3.3368 |