| National Provider Identifier [NPI]: | 1316993736 |
| Last Name Of The Provider | TIERNEY |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2711 RANDOLPH RD |
| Street Address 2 Of The Provider | BLDG 400 |
| City Of The Provider | CHARLOTTE |
| Zip Code Of The Provider | 282072027 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 18156 |
| Number Of Medicare Beneficiaries | 734 |
| Total Submitted Charge Amount | 1331220.5 |
| Total Medicare Allowed Amount | 403688.63 |
| Total Medicare Payment Amount | 313248.8 |
| Total Medicare Standardized Payment Amount | 324161.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 12713 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 110695 |
| Total Drug Medicare AllowedAmount | 48517.57 |
| Total Drug Medicare PaymentAmount | 36219.45 |
| Total Drug Medicare Standardized Payment Amount | 36219.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 5443 |
| Number Of Medicare Beneficiaries With Medical Services | 734 |
| Total Medical Submitted Charge Amount | 1220525.5 |
| Total Medical Medicare Allowed Amount | 355171.06 |
| Total Medical Medicare Payment Amount | 277029.35 |
| Total Medical Medicare Standardized Payment Amount | 287942.29 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 353 |
| Number Of Male Beneficiaries | 381 |
| Number Of Non Hispanic White Beneficiaries | 403 |
| Number Of Black or African American Beneficiaries | 299 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 528 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 206 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 4.2892 |