National Provider Identifier [NPI]: |
1063610947 |
Last Name Of The Provider |
LAIRD |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2825 E BARNETT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEDFORD |
Zip Code Of The Provider |
975048332 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1147 |
Number Of Medicare Beneficiaries |
926 |
Total Submitted Charge Amount |
522222 |
Total Medicare Allowed Amount |
149921.01 |
Total Medicare Payment Amount |
110443.08 |
Total Medicare Standardized Payment Amount |
108461.69 |
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 |
39 |
Number Of Medical Services |
1147 |
Number Of Medicare Beneficiaries With Medical Services |
926 |
Total Medical Submitted Charge Amount |
522222 |
Total Medical Medicare Allowed Amount |
149921.01 |
Total Medical Medicare Payment Amount |
110443.08 |
Total Medical Medicare Standardized Payment Amount |
108461.69 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
326 |
Number Of Beneficiaries Age 75 to 84 |
236 |
Number Of Beneficiaries Age Greater 84 |
181 |
Number Of Female Beneficiaries |
531 |
Number Of Male Beneficiaries |
395 |
Number Of Non Hispanic White Beneficiaries |
851 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
13 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
686 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
240 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4661 |