National Provider Identifier [NPI]: |
1982789384 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
TYLER |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4905 W 112TH TER |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEAWOOD |
Zip Code Of The Provider |
662111782 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
791 |
Number Of Medicare Beneficiaries |
302 |
Total Submitted Charge Amount |
64915.5 |
Total Medicare Allowed Amount |
44730.9 |
Total Medicare Payment Amount |
31471.44 |
Total Medicare Standardized Payment Amount |
33591.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
274 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
1737.5 |
Total Drug Medicare AllowedAmount |
182.31 |
Total Drug Medicare PaymentAmount |
130.86 |
Total Drug Medicare Standardized Payment Amount |
130.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
517 |
Number Of Medicare Beneficiaries With Medical Services |
302 |
Total Medical Submitted Charge Amount |
63178 |
Total Medical Medicare Allowed Amount |
44548.59 |
Total Medical Medicare Payment Amount |
31340.58 |
Total Medical Medicare Standardized Payment Amount |
33460.16 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
151 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
280 |
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 |
270 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9581 |