National Provider Identifier [NPI]: |
1750692810 |
Last Name Of The Provider |
MARCHION |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
777 N RAYMOND ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOISE |
Zip Code Of The Provider |
837049251 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
113 |
Total Submitted Charge Amount |
32538.8 |
Total Medicare Allowed Amount |
17564.01 |
Total Medicare Payment Amount |
13486.2 |
Total Medicare Standardized Payment Amount |
13730.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1370 |
Total Drug Medicare AllowedAmount |
1229.15 |
Total Drug Medicare PaymentAmount |
1202.65 |
Total Drug Medicare Standardized Payment Amount |
1202.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
254 |
Number Of Medicare Beneficiaries With Medical Services |
113 |
Total Medical Submitted Charge Amount |
31168.8 |
Total Medical Medicare Allowed Amount |
16334.86 |
Total Medical Medicare Payment Amount |
12283.55 |
Total Medical Medicare Standardized Payment Amount |
12527.95 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
21 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2876 |