National Provider Identifier [NPI]: |
1326233065 |
Last Name Of The Provider |
GERHARD |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16770 SW EDY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHERWOOD |
Zip Code Of The Provider |
971409678 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
639 |
Number Of Medicare Beneficiaries |
193 |
Total Submitted Charge Amount |
137545 |
Total Medicare Allowed Amount |
45357.05 |
Total Medicare Payment Amount |
30381.03 |
Total Medicare Standardized Payment Amount |
30490.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
100 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
2878 |
Total Drug Medicare AllowedAmount |
1831.76 |
Total Drug Medicare PaymentAmount |
1602.47 |
Total Drug Medicare Standardized Payment Amount |
1602.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
539 |
Number Of Medicare Beneficiaries With Medical Services |
193 |
Total Medical Submitted Charge Amount |
134667 |
Total Medical Medicare Allowed Amount |
43525.29 |
Total Medical Medicare Payment Amount |
28778.56 |
Total Medical Medicare Standardized Payment Amount |
28887.58 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
173 |
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 |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
28 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0215 |