National Provider Identifier [NPI]: |
1336104009 |
Last Name Of The Provider |
TWYMAN |
First Name Of The Provider |
MARLON |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1152 W THIRD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAYTON |
Zip Code Of The Provider |
454026812 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1787 |
Number Of Medicare Beneficiaries |
257 |
Total Submitted Charge Amount |
147817 |
Total Medicare Allowed Amount |
97573.73 |
Total Medicare Payment Amount |
61564.97 |
Total Medicare Standardized Payment Amount |
64816.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
336 |
Number Of Medicare Beneficiaries With Drug Services |
98 |
Total Drug Submitted ChargeAmount |
7057 |
Total Drug Medicare AllowedAmount |
3416.43 |
Total Drug Medicare PaymentAmount |
3196.91 |
Total Drug Medicare Standardized Payment Amount |
3196.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
1451 |
Number Of Medicare Beneficiaries With Medical Services |
257 |
Total Medical Submitted Charge Amount |
140760 |
Total Medical Medicare Allowed Amount |
94157.3 |
Total Medical Medicare Payment Amount |
58368.06 |
Total Medical Medicare Standardized Payment Amount |
61619.52 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
92 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
117 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
241 |
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 |
142 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3725 |