National Provider Identifier [NPI]: |
1518928605 |
Last Name Of The Provider |
ARNOLD |
First Name Of The Provider |
THOMAS |
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 |
800 E DAWSON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757012036 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
203 |
Number Of Services |
8645 |
Number Of Medicare Beneficiaries |
6058 |
Total Submitted Charge Amount |
870779.04 |
Total Medicare Allowed Amount |
234149.5 |
Total Medicare Payment Amount |
180617.22 |
Total Medicare Standardized Payment Amount |
189979.09 |
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 |
203 |
Number Of Medical Services |
8645 |
Number Of Medicare Beneficiaries With Medical Services |
6058 |
Total Medical Submitted Charge Amount |
870779.04 |
Total Medical Medicare Allowed Amount |
234149.5 |
Total Medical Medicare Payment Amount |
180617.22 |
Total Medical Medicare Standardized Payment Amount |
189979.09 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
1015 |
Number Of Beneficiaries Age 65 to 74 |
2262 |
Number Of Beneficiaries Age 75 to 84 |
1907 |
Number Of Beneficiaries Age Greater 84 |
874 |
Number Of Female Beneficiaries |
3349 |
Number Of Male Beneficiaries |
2709 |
Number Of Non Hispanic White Beneficiaries |
5103 |
Number Of Black or African American Beneficiaries |
735 |
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
170 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
25 |
Number Of Beneficiaries With Medicare Only Entitlement |
4569 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1489 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.696 |