National Provider Identifier [NPI]: |
1033196043 |
Last Name Of The Provider |
JONES |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1400 8TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761044110 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
833 |
Number Of Medicare Beneficiaries |
530 |
Total Submitted Charge Amount |
582830 |
Total Medicare Allowed Amount |
98190.34 |
Total Medicare Payment Amount |
75561.69 |
Total Medicare Standardized Payment Amount |
77299.91 |
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 |
48 |
Number Of Medical Services |
833 |
Number Of Medicare Beneficiaries With Medical Services |
530 |
Total Medical Submitted Charge Amount |
582830 |
Total Medical Medicare Allowed Amount |
98190.34 |
Total Medical Medicare Payment Amount |
75561.69 |
Total Medical Medicare Standardized Payment Amount |
77299.91 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
178 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
123 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
221 |
Number Of Non Hispanic White Beneficiaries |
291 |
Number Of Black or African American Beneficiaries |
151 |
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 |
316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
214 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
3.2081 |