National Provider Identifier [NPI]: |
1306936935 |
Last Name Of The Provider |
BEALS |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
590 WAKARA WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841081200 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
104 |
Number Of Services |
628 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
434073.83 |
Total Medicare Allowed Amount |
109892.03 |
Total Medicare Payment Amount |
84188.03 |
Total Medicare Standardized Payment Amount |
86033.1 |
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 |
104 |
Number Of Medical Services |
628 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
434073.83 |
Total Medical Medicare Allowed Amount |
109892.03 |
Total Medical Medicare Payment Amount |
84188.03 |
Total Medical Medicare Standardized Payment Amount |
86033.1 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
159 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
245 |
Number Of Black or African American Beneficiaries |
0 |
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 |
241 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9768 |