National Provider Identifier [NPI]: |
1255337259 |
Last Name Of The Provider |
YOUNG |
First Name Of The Provider |
THOMAS |
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 |
16792 CONNEAUT LAKE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEADVILLE |
Zip Code Of The Provider |
163353748 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
836 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
198112 |
Total Medicare Allowed Amount |
65047.78 |
Total Medicare Payment Amount |
47803.99 |
Total Medicare Standardized Payment Amount |
49015.14 |
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 |
15 |
Number Of Medical Services |
836 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
198112 |
Total Medical Medicare Allowed Amount |
65047.78 |
Total Medical Medicare Payment Amount |
47803.99 |
Total Medical Medicare Standardized Payment Amount |
49015.14 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
151 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
240 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
83 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.718 |