National Provider Identifier [NPI]: |
1093880981 |
Last Name Of The Provider |
TIECHE |
First Name Of The Provider |
STEVEN |
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 |
1920 SW 20TH PL |
Street Address 2 Of The Provider |
STE 201 |
City Of The Provider |
OCALA |
Zip Code Of The Provider |
344717881 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1084 |
Number Of Medicare Beneficiaries |
297 |
Total Submitted Charge Amount |
1364206.35 |
Total Medicare Allowed Amount |
719815.55 |
Total Medicare Payment Amount |
556929.81 |
Total Medicare Standardized Payment Amount |
570966.95 |
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 |
28 |
Number Of Medical Services |
1084 |
Number Of Medicare Beneficiaries With Medical Services |
297 |
Total Medical Submitted Charge Amount |
1364206.35 |
Total Medical Medicare Allowed Amount |
719815.55 |
Total Medical Medicare Payment Amount |
556929.81 |
Total Medical Medicare Standardized Payment Amount |
570966.95 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
264 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
260 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6101 |