National Provider Identifier [NPI]: |
1326207051 |
Last Name Of The Provider |
PASTOR |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
21911 76TH AVE W |
Street Address 2 Of The Provider |
SUITE 106 |
City Of The Provider |
EDMONDS |
Zip Code Of The Provider |
98026 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
150 |
Number Of Medicare Beneficiaries |
114 |
Total Submitted Charge Amount |
34815.64 |
Total Medicare Allowed Amount |
12917.78 |
Total Medicare Payment Amount |
9034.12 |
Total Medicare Standardized Payment Amount |
8737.97 |
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 |
13 |
Number Of Medical Services |
150 |
Number Of Medicare Beneficiaries With Medical Services |
114 |
Total Medical Submitted Charge Amount |
34815.64 |
Total Medical Medicare Allowed Amount |
12917.78 |
Total Medical Medicare Payment Amount |
9034.12 |
Total Medical Medicare Standardized Payment Amount |
8737.97 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
66 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
100 |
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
17 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3753 |