National Provider Identifier [NPI]: |
1952309759 |
Last Name Of The Provider |
TSOUTSOURIS |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9105A INDIANAPOLIS BLVD |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
HIGHLAND |
Zip Code Of The Provider |
463222591 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1391 |
Number Of Medicare Beneficiaries |
288 |
Total Submitted Charge Amount |
181750 |
Total Medicare Allowed Amount |
73977.67 |
Total Medicare Payment Amount |
53394.81 |
Total Medicare Standardized Payment Amount |
57319.48 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
155 |
Number Of Black or African American Beneficiaries |
112 |
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 |
210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7007 |