National Provider Identifier [NPI]: |
1225349715 |
Last Name Of The Provider |
RAISSIAN |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1955 W FRYE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHANDLER |
Zip Code Of The Provider |
852246282 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
740 |
Number Of Medicare Beneficiaries |
471 |
Total Submitted Charge Amount |
483009 |
Total Medicare Allowed Amount |
80220.82 |
Total Medicare Payment Amount |
62635.92 |
Total Medicare Standardized Payment Amount |
63061.55 |
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 |
14 |
Number Of Medical Services |
740 |
Number Of Medicare Beneficiaries With Medical Services |
471 |
Total Medical Submitted Charge Amount |
483009 |
Total Medical Medicare Allowed Amount |
80220.82 |
Total Medical Medicare Payment Amount |
62635.92 |
Total Medical Medicare Standardized Payment Amount |
63061.55 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
168 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
91 |
Number Of Female Beneficiaries |
255 |
Number Of Male Beneficiaries |
216 |
Number Of Non Hispanic White Beneficiaries |
380 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
15 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
398 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9804 |