National Provider Identifier [NPI]: |
1518048263 |
Last Name Of The Provider |
TYLER |
First Name Of The Provider |
MELANIE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1611 S GREEN RD STE 160 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SOUTH EUCLID |
Zip Code Of The Provider |
441216100 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
1890 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
117641 |
Total Medicare Allowed Amount |
79886.02 |
Total Medicare Payment Amount |
56916.84 |
Total Medicare Standardized Payment Amount |
59491.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
111 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
6385 |
Total Drug Medicare AllowedAmount |
3788.27 |
Total Drug Medicare PaymentAmount |
3558.88 |
Total Drug Medicare Standardized Payment Amount |
3558.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1779 |
Number Of Medicare Beneficiaries With Medical Services |
267 |
Total Medical Submitted Charge Amount |
111256 |
Total Medical Medicare Allowed Amount |
76097.75 |
Total Medical Medicare Payment Amount |
53357.96 |
Total Medical Medicare Standardized Payment Amount |
55932.58 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
127 |
Number Of Black or African American Beneficiaries |
130 |
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 |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
4 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0509 |