National Provider Identifier [NPI]: |
1841224946 |
Last Name Of The Provider |
CHILCOTE |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9100 W 74TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHAWNEE MISSION |
Zip Code Of The Provider |
662044004 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
762 |
Number Of Medicare Beneficiaries |
608 |
Total Submitted Charge Amount |
602532 |
Total Medicare Allowed Amount |
101935.83 |
Total Medicare Payment Amount |
77630.9 |
Total Medicare Standardized Payment Amount |
81171.74 |
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 |
25 |
Number Of Medical Services |
762 |
Number Of Medicare Beneficiaries With Medical Services |
608 |
Total Medical Submitted Charge Amount |
602532 |
Total Medical Medicare Allowed Amount |
101935.83 |
Total Medical Medicare Payment Amount |
77630.9 |
Total Medical Medicare Standardized Payment Amount |
81171.74 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
190 |
Number Of Beneficiaries Age 75 to 84 |
168 |
Number Of Beneficiaries Age Greater 84 |
143 |
Number Of Female Beneficiaries |
367 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
533 |
Number Of Black or African American Beneficiaries |
39 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
476 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7832 |