National Provider Identifier [NPI]: |
1811174493 |
Last Name Of The Provider |
TIMMONS |
First Name Of The Provider |
TAMMY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
707 N ALVERNON WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857111827 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
263 |
Number Of Medicare Beneficiaries |
39 |
Total Submitted Charge Amount |
10071.5 |
Total Medicare Allowed Amount |
2759.85 |
Total Medicare Payment Amount |
2316.16 |
Total Medicare Standardized Payment Amount |
2376.9 |
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 |
37 |
Number Of Medical Services |
263 |
Number Of Medicare Beneficiaries With Medical Services |
39 |
Total Medical Submitted Charge Amount |
10071.5 |
Total Medical Medicare Allowed Amount |
2759.85 |
Total Medical Medicare Payment Amount |
2316.16 |
Total Medical Medicare Standardized Payment Amount |
2376.9 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
19 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
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Percent Of With Cancer |
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Percent Of With Heart Failure |
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Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
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Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
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Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.3481 |