National Provider Identifier [NPI]: |
1386649465 |
Last Name Of The Provider |
TINNES |
First Name Of The Provider |
GARRY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
550 S LANDMARK AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BLOOMINGTON |
Zip Code Of The Provider |
474033239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1792 |
Number Of Medicare Beneficiaries |
582 |
Total Submitted Charge Amount |
220085 |
Total Medicare Allowed Amount |
148077.05 |
Total Medicare Payment Amount |
112352.06 |
Total Medicare Standardized Payment Amount |
118554.04 |
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 |
27 |
Number Of Medical Services |
1792 |
Number Of Medicare Beneficiaries With Medical Services |
582 |
Total Medical Submitted Charge Amount |
220085 |
Total Medical Medicare Allowed Amount |
148077.05 |
Total Medical Medicare Payment Amount |
112352.06 |
Total Medical Medicare Standardized Payment Amount |
118554.04 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
171 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
565 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
399 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
183 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9488 |