National Provider Identifier [NPI]: |
1447283205 |
Last Name Of The Provider |
REAY |
First Name Of The Provider |
CAROLINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5330 NE GLISAN ST |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972133069 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
596 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
125401 |
Total Medicare Allowed Amount |
40788.27 |
Total Medicare Payment Amount |
27757.6 |
Total Medicare Standardized Payment Amount |
27443.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
100 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
1625 |
Total Drug Medicare AllowedAmount |
991.6 |
Total Drug Medicare PaymentAmount |
947.36 |
Total Drug Medicare Standardized Payment Amount |
947.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
496 |
Number Of Medicare Beneficiaries With Medical Services |
141 |
Total Medical Submitted Charge Amount |
123776 |
Total Medical Medicare Allowed Amount |
39796.67 |
Total Medical Medicare Payment Amount |
26810.24 |
Total Medical Medicare Standardized Payment Amount |
26496.19 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
121 |
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 |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0863 |