| National Provider Identifier [NPI]: | 1497724413 |
| Last Name Of The Provider | TILGNER |
| First Name Of The Provider | THERON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1720 MESQUITE AVE |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | LAKE HAVASU CITY |
| Zip Code Of The Provider | 864035602 |
| 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 | 113 |
| Number Of Services | 3955 |
| Number Of Medicare Beneficiaries | 887 |
| Total Submitted Charge Amount | 1562292.29 |
| Total Medicare Allowed Amount | 446969.53 |
| Total Medicare Payment Amount | 341733 |
| Total Medicare Standardized Payment Amount | 349690.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 600 |
| Number Of Medicare Beneficiaries With Drug Services | 365 |
| Total Drug Submitted ChargeAmount | 68290 |
| Total Drug Medicare AllowedAmount | 27226.76 |
| Total Drug Medicare PaymentAmount | 21162.89 |
| Total Drug Medicare Standardized Payment Amount | 21162.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 3355 |
| Number Of Medicare Beneficiaries With Medical Services | 887 |
| Total Medical Submitted Charge Amount | 1494002.29 |
| Total Medical Medicare Allowed Amount | 419742.77 |
| Total Medical Medicare Payment Amount | 320570.11 |
| Total Medical Medicare Standardized Payment Amount | 328527.26 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 440 |
| Number Of Beneficiaries Age 75 to 84 | 298 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 529 |
| Number Of Male Beneficiaries | 358 |
| Number Of Non Hispanic White Beneficiaries | 849 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 828 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0153 |