National Provider Identifier [NPI]: |
1861452336 |
Last Name Of The Provider |
MCCAULEY |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4350 E CAMELBACK RD |
Street Address 2 Of The Provider |
SUITE F-100 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850182701 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
4160 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
422205 |
Total Medicare Allowed Amount |
209763.08 |
Total Medicare Payment Amount |
156928.27 |
Total Medicare Standardized Payment Amount |
163034.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
95 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
2561 |
Total Drug Medicare AllowedAmount |
1365.5 |
Total Drug Medicare PaymentAmount |
1329.53 |
Total Drug Medicare Standardized Payment Amount |
1329.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
78 |
Number Of Medical Services |
4065 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
419644 |
Total Medical Medicare Allowed Amount |
208397.58 |
Total Medical Medicare Payment Amount |
155598.74 |
Total Medical Medicare Standardized Payment Amount |
161704.89 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
309 |
Number Of Black or African American Beneficiaries |
|
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 |
320 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9459 |