National Provider Identifier [NPI]: |
1447218425 |
Last Name Of The Provider |
ENDEAN |
First Name Of The Provider |
TY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6369 E TANQUE VERDE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857153850 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
418 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
253234 |
Total Medicare Allowed Amount |
59300.96 |
Total Medicare Payment Amount |
44079.51 |
Total Medicare Standardized Payment Amount |
44372.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
81 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
44270 |
Total Drug Medicare AllowedAmount |
13124.71 |
Total Drug Medicare PaymentAmount |
10285.38 |
Total Drug Medicare Standardized Payment Amount |
10285.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
337 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
208964 |
Total Medical Medicare Allowed Amount |
46176.25 |
Total Medical Medicare Payment Amount |
33794.13 |
Total Medical Medicare Standardized Payment Amount |
34087.41 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
80 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
53 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
99 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
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 |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
13 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
44 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6855 |