National Provider Identifier [NPI]: |
1588623797 |
Last Name Of The Provider |
TYLEN |
First Name Of The Provider |
ULF |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4860 Y ST |
Street Address 2 Of The Provider |
SUITE 3100 ACC |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958172307 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1360 |
Number Of Medicare Beneficiaries |
1149 |
Total Submitted Charge Amount |
182702 |
Total Medicare Allowed Amount |
33908.95 |
Total Medicare Payment Amount |
25619.55 |
Total Medicare Standardized Payment Amount |
25071.11 |
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 |
19 |
Number Of Medical Services |
1360 |
Number Of Medicare Beneficiaries With Medical Services |
1149 |
Total Medical Submitted Charge Amount |
182702 |
Total Medical Medicare Allowed Amount |
33908.95 |
Total Medical Medicare Payment Amount |
25619.55 |
Total Medical Medicare Standardized Payment Amount |
25071.11 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
227 |
Number Of Beneficiaries Age 65 to 74 |
469 |
Number Of Beneficiaries Age 75 to 84 |
329 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
589 |
Number Of Male Beneficiaries |
560 |
Number Of Non Hispanic White Beneficiaries |
774 |
Number Of Black or African American Beneficiaries |
131 |
Number Of AsianPacific Islander Beneficiaries |
111 |
Number Of Hispanic Beneficiaries |
108 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
737 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
412 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.1986 |