National Provider Identifier [NPI]: |
1508949439 |
Last Name Of The Provider |
WHITNEY |
First Name Of The Provider |
ALLENE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
101 E 26TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984211108 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
218 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
61214 |
Total Medicare Allowed Amount |
19655.56 |
Total Medicare Payment Amount |
13742.48 |
Total Medicare Standardized Payment Amount |
10602.69 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
82 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
75 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
24 |
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
48 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6069 |