National Provider Identifier [NPI]: |
1821198037 |
Last Name Of The Provider |
TILLMAN |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2708 STERNBERG DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
HAYS |
Zip Code Of The Provider |
67601 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
13486 |
Number Of Medicare Beneficiaries |
1796 |
Total Submitted Charge Amount |
1761715 |
Total Medicare Allowed Amount |
1013471.61 |
Total Medicare Payment Amount |
755804.08 |
Total Medicare Standardized Payment Amount |
774146.87 |
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 |
73 |
Number Of Medical Services |
13486 |
Number Of Medicare Beneficiaries With Medical Services |
1796 |
Total Medical Submitted Charge Amount |
1761715 |
Total Medical Medicare Allowed Amount |
1013471.61 |
Total Medical Medicare Payment Amount |
755804.08 |
Total Medical Medicare Standardized Payment Amount |
774146.87 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
686 |
Number Of Beneficiaries Age 75 to 84 |
752 |
Number Of Beneficiaries Age Greater 84 |
325 |
Number Of Female Beneficiaries |
890 |
Number Of Male Beneficiaries |
906 |
Number Of Non Hispanic White Beneficiaries |
1776 |
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 |
1753 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9604 |