National Provider Identifier [NPI]: |
1548287550 |
Last Name Of The Provider |
TFAILI |
First Name Of The Provider |
AMER |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 W 5TH AVE |
Street Address 2 Of The Provider |
SUITE 301 |
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992042823 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Critical Care (Intensivists) |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
366 |
Number Of Medicare Beneficiaries |
136 |
Total Submitted Charge Amount |
404886 |
Total Medicare Allowed Amount |
53651.14 |
Total Medicare Payment Amount |
41982.91 |
Total Medicare Standardized Payment Amount |
41759.32 |
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 |
21 |
Number Of Medical Services |
366 |
Number Of Medicare Beneficiaries With Medical Services |
136 |
Total Medical Submitted Charge Amount |
404886 |
Total Medical Medicare Allowed Amount |
53651.14 |
Total Medical Medicare Payment Amount |
41982.91 |
Total Medical Medicare Standardized Payment Amount |
41759.32 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
67 |
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 |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
43 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
60 |
Percent Of With Chronic Kidney Disease |
69 |
Percent Of With Chronic Obstructive Pulmonary Disease |
45 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.1798 |