National Provider Identifier [NPI]: |
1003814526 |
Last Name Of The Provider |
TYNER |
First Name Of The Provider |
TROY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O.,F.A.C.O.I. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2510 COMMONS BLVD |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
BEAVERCREEK |
Zip Code Of The Provider |
454313820 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
1750 |
Number Of Medicare Beneficiaries |
575 |
Total Submitted Charge Amount |
407351 |
Total Medicare Allowed Amount |
229617.22 |
Total Medicare Payment Amount |
172637.34 |
Total Medicare Standardized Payment Amount |
180824.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
33 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
1090 |
Total Drug Medicare AllowedAmount |
859.37 |
Total Drug Medicare PaymentAmount |
832.67 |
Total Drug Medicare Standardized Payment Amount |
832.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1717 |
Number Of Medicare Beneficiaries With Medical Services |
575 |
Total Medical Submitted Charge Amount |
406261 |
Total Medical Medicare Allowed Amount |
228757.85 |
Total Medical Medicare Payment Amount |
171804.67 |
Total Medical Medicare Standardized Payment Amount |
179991.74 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
162 |
Number Of Beneficiaries Age 65 to 74 |
199 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
335 |
Number Of Male Beneficiaries |
240 |
Number Of Non Hispanic White Beneficiaries |
489 |
Number Of Black or African American Beneficiaries |
71 |
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 |
358 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
217 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2603 |