National Provider Identifier [NPI]: |
1952587750 |
Last Name Of The Provider |
HANKS |
First Name Of The Provider |
TYRONE |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2927 N 7TH AVE |
Street Address 2 Of The Provider |
PEPPERTREE - FAMILY MEDICINE #3 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850134102 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
105 |
Number Of Services |
9060 |
Number Of Medicare Beneficiaries |
2536 |
Total Submitted Charge Amount |
839429 |
Total Medicare Allowed Amount |
425082.39 |
Total Medicare Payment Amount |
290584.32 |
Total Medicare Standardized Payment Amount |
288150.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
2981 |
Number Of Medicare Beneficiaries With Drug Services |
598 |
Total Drug Submitted ChargeAmount |
102493 |
Total Drug Medicare AllowedAmount |
3261.57 |
Total Drug Medicare PaymentAmount |
2443.73 |
Total Drug Medicare Standardized Payment Amount |
2443.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
90 |
Number Of Medical Services |
6079 |
Number Of Medicare Beneficiaries With Medical Services |
2535 |
Total Medical Submitted Charge Amount |
736936 |
Total Medical Medicare Allowed Amount |
421820.82 |
Total Medical Medicare Payment Amount |
288140.59 |
Total Medical Medicare Standardized Payment Amount |
285706.89 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
622 |
Number Of Beneficiaries Age 65 to 74 |
1201 |
Number Of Beneficiaries Age 75 to 84 |
535 |
Number Of Beneficiaries Age Greater 84 |
178 |
Number Of Female Beneficiaries |
1559 |
Number Of Male Beneficiaries |
977 |
Number Of Non Hispanic White Beneficiaries |
1784 |
Number Of Black or African American Beneficiaries |
382 |
Number Of AsianPacific Islander Beneficiaries |
93 |
Number Of Hispanic Beneficiaries |
214 |
Number Of American Indian Alaska Native Beneficiaries |
13 |
Number Of Beneficiaries With Race Not Else where Classified |
50 |
Number Of Beneficiaries With Medicare Only Entitlement |
2010 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
526 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0484 |