| National Provider Identifier [NPI]: | 1790800357 |
| Last Name Of The Provider | MCCARTY |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | C-PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 450 WASHINGTON JACKSON RD # B |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | EATON |
| Zip Code Of The Provider | 453208699 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 862 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 36928 |
| Total Medicare Allowed Amount | 24295.32 |
| Total Medicare Payment Amount | 16983.65 |
| Total Medicare Standardized Payment Amount | 22123.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 400 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 2194 |
| Total Drug Medicare AllowedAmount | 705.49 |
| Total Drug Medicare PaymentAmount | 494.28 |
| Total Drug Medicare Standardized Payment Amount | 494.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 462 |
| Number Of Medicare Beneficiaries With Medical Services | 176 |
| Total Medical Submitted Charge Amount | 34734 |
| Total Medical Medicare Allowed Amount | 23589.83 |
| Total Medical Medicare Payment Amount | 16489.37 |
| Total Medical Medicare Standardized Payment Amount | 21629.37 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3132 |