National Provider Identifier [NPI]: |
1336112184 |
Last Name Of The Provider |
TIMMING |
First Name Of The Provider |
RICHARD |
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 |
401 PHALEN BLVD |
Street Address 2 Of The Provider |
MAIL STOP 41102E |
City Of The Provider |
ST PAUL |
Zip Code Of The Provider |
551015302 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
6434 |
Number Of Medicare Beneficiaries |
141 |
Total Submitted Charge Amount |
228768 |
Total Medicare Allowed Amount |
84257.16 |
Total Medicare Payment Amount |
59656.27 |
Total Medicare Standardized Payment Amount |
60628.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
6070 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
119000 |
Total Drug Medicare AllowedAmount |
44518.01 |
Total Drug Medicare PaymentAmount |
30986.97 |
Total Drug Medicare Standardized Payment Amount |
30986.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
364 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
109768 |
Total Medical Medicare Allowed Amount |
39739.15 |
Total Medical Medicare Payment Amount |
28669.3 |
Total Medical Medicare Standardized Payment Amount |
29641.27 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
109 |
Number Of Black or African American Beneficiaries |
20 |
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 |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
1.4523 |