National Provider Identifier [NPI]: |
1275532715 |
Last Name Of The Provider |
TSUDA |
First Name Of The Provider |
SUE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2605 COLLEGE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CONWAY |
Zip Code Of The Provider |
720346133 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
193 |
Number Of Services |
725774 |
Number Of Medicare Beneficiaries |
1039 |
Total Submitted Charge Amount |
12725358.75 |
Total Medicare Allowed Amount |
6884925.06 |
Total Medicare Payment Amount |
5313880.44 |
Total Medicare Standardized Payment Amount |
5394418.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
86 |
Number Of Drug Services |
691028 |
Number Of Medicare Beneficiaries With Drug Services |
448 |
Total Drug Submitted ChargeAmount |
9728621.59 |
Total Drug Medicare AllowedAmount |
5689053.7 |
Total Drug Medicare PaymentAmount |
4376860.65 |
Total Drug Medicare Standardized Payment Amount |
4376860.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
107 |
Number Of Medical Services |
34746 |
Number Of Medicare Beneficiaries With Medical Services |
1039 |
Total Medical Submitted Charge Amount |
2996737.16 |
Total Medical Medicare Allowed Amount |
1195871.36 |
Total Medical Medicare Payment Amount |
937019.79 |
Total Medical Medicare Standardized Payment Amount |
1017557.51 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
153 |
Number Of Beneficiaries Age 65 to 74 |
398 |
Number Of Beneficiaries Age 75 to 84 |
345 |
Number Of Beneficiaries Age Greater 84 |
143 |
Number Of Female Beneficiaries |
705 |
Number Of Male Beneficiaries |
334 |
Number Of Non Hispanic White Beneficiaries |
945 |
Number Of Black or African American Beneficiaries |
81 |
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 |
840 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
199 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
45 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7118 |