National Provider Identifier [NPI]: |
1629064019 |
Last Name Of The Provider |
TYLER |
First Name Of The Provider |
HAROLD |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
620 E COLLEGE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOMER |
Zip Code Of The Provider |
710403202 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
279 |
Number Of Medicare Beneficiaries |
210 |
Total Submitted Charge Amount |
60902 |
Total Medicare Allowed Amount |
12345.76 |
Total Medicare Payment Amount |
8507.4 |
Total Medicare Standardized Payment Amount |
8771.1 |
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 |
12 |
Number Of Medical Services |
279 |
Number Of Medicare Beneficiaries With Medical Services |
210 |
Total Medical Submitted Charge Amount |
60902 |
Total Medical Medicare Allowed Amount |
12345.76 |
Total Medical Medicare Payment Amount |
8507.4 |
Total Medical Medicare Standardized Payment Amount |
8771.1 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
60 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
106 |
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 |
105 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7302 |