National Provider Identifier [NPI]: |
1952419491 |
Last Name Of The Provider |
TRAN |
First Name Of The Provider |
AUDREY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
314 MARTIN LUTHER KING JR WAY |
Street Address 2 Of The Provider |
#11 |
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984054250 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
3539 |
Number Of Medicare Beneficiaries |
341 |
Total Submitted Charge Amount |
2283053 |
Total Medicare Allowed Amount |
669965.38 |
Total Medicare Payment Amount |
524485.44 |
Total Medicare Standardized Payment Amount |
511599.19 |
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 |
3539 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
2283053 |
Total Medical Medicare Allowed Amount |
669965.38 |
Total Medical Medicare Payment Amount |
524485.44 |
Total Medical Medicare Standardized Payment Amount |
511599.19 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
157 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
169 |
Number Of Non Hispanic White Beneficiaries |
310 |
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 |
305 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
69 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5504 |