National Provider Identifier [NPI]: |
1235193178 |
Last Name Of The Provider |
DESANTIS |
First Name Of The Provider |
ANTHONY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4225 ROOSEVELT WAY NE |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981056099 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
345 |
Number Of Medicare Beneficiaries |
230 |
Total Submitted Charge Amount |
58666.2 |
Total Medicare Allowed Amount |
28598.48 |
Total Medicare Payment Amount |
19451.95 |
Total Medicare Standardized Payment Amount |
19252.77 |
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 |
9 |
Number Of Medical Services |
345 |
Number Of Medicare Beneficiaries With Medical Services |
230 |
Total Medical Submitted Charge Amount |
58666.2 |
Total Medical Medicare Allowed Amount |
28598.48 |
Total Medical Medicare Payment Amount |
19451.95 |
Total Medical Medicare Standardized Payment Amount |
19252.77 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
138 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
183 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5875 |