| National Provider Identifier [NPI]: | 1114089844 |
| Last Name Of The Provider | TIEMAN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1584 E COMMON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW BRAUNFELS |
| Zip Code Of The Provider | 781303113 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 10256 |
| Number Of Medicare Beneficiaries | 1505 |
| Total Submitted Charge Amount | 482984.96 |
| Total Medicare Allowed Amount | 435692.35 |
| Total Medicare Payment Amount | 306156.97 |
| Total Medicare Standardized Payment Amount | 325052.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 277 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 554 |
| Total Drug Medicare AllowedAmount | 494.18 |
| Total Drug Medicare PaymentAmount | 328.45 |
| Total Drug Medicare Standardized Payment Amount | 328.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 9979 |
| Number Of Medicare Beneficiaries With Medical Services | 1505 |
| Total Medical Submitted Charge Amount | 482430.96 |
| Total Medical Medicare Allowed Amount | 435198.17 |
| Total Medical Medicare Payment Amount | 305828.52 |
| Total Medical Medicare Standardized Payment Amount | 324724.49 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 677 |
| Number Of Beneficiaries Age 75 to 84 | 566 |
| Number Of Beneficiaries Age Greater 84 | 235 |
| Number Of Female Beneficiaries | 751 |
| Number Of Male Beneficiaries | 754 |
| Number Of Non Hispanic White Beneficiaries | 1464 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1486 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8935 |