National Provider Identifier [NPI]: |
1720095235 |
Last Name Of The Provider |
TINER |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1044 S FAIR OAKS AVE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
PASADENA |
Zip Code Of The Provider |
911052622 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Plastic and Reconstructive Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
292 |
Number Of Medicare Beneficiaries |
96 |
Total Submitted Charge Amount |
645222 |
Total Medicare Allowed Amount |
71520.08 |
Total Medicare Payment Amount |
55843.54 |
Total Medicare Standardized Payment Amount |
51628.77 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
65 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.062 |