| National Provider Identifier [NPI]: | 1588794622 |
| Last Name Of The Provider | TIOCO |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9132 COLUMBIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 463212907 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 5292 |
| Number Of Medicare Beneficiaries | 831 |
| Total Submitted Charge Amount | 1851172 |
| Total Medicare Allowed Amount | 425002.96 |
| Total Medicare Payment Amount | 316256.79 |
| Total Medicare Standardized Payment Amount | 339006.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1795 |
| Number Of Medicare Beneficiaries With Drug Services | 199 |
| Total Drug Submitted ChargeAmount | 37767 |
| Total Drug Medicare AllowedAmount | 2686.46 |
| Total Drug Medicare PaymentAmount | 1941.29 |
| Total Drug Medicare Standardized Payment Amount | 1941.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 3497 |
| Number Of Medicare Beneficiaries With Medical Services | 831 |
| Total Medical Submitted Charge Amount | 1813405 |
| Total Medical Medicare Allowed Amount | 422316.5 |
| Total Medical Medicare Payment Amount | 314315.5 |
| Total Medical Medicare Standardized Payment Amount | 337065.52 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 359 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 534 |
| Number Of Male Beneficiaries | 297 |
| Number Of Non Hispanic White Beneficiaries | 713 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 796 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1863 |