National Provider Identifier [NPI]: |
1972822591 |
Last Name Of The Provider |
HAWKINS |
First Name Of The Provider |
CHRISTOPHER |
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 |
2020 CAPITOL ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALEM |
Zip Code Of The Provider |
973010644 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
666 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
52438 |
Total Medicare Allowed Amount |
21793.48 |
Total Medicare Payment Amount |
17136.97 |
Total Medicare Standardized Payment Amount |
17906.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
95 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
901 |
Total Drug Medicare AllowedAmount |
552.43 |
Total Drug Medicare PaymentAmount |
535.05 |
Total Drug Medicare Standardized Payment Amount |
535.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
571 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
51537 |
Total Medical Medicare Allowed Amount |
21241.05 |
Total Medical Medicare Payment Amount |
16601.92 |
Total Medical Medicare Standardized Payment Amount |
17371.55 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
46 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
63 |
Number Of Male Beneficiaries |
44 |
Number Of Non Hispanic White Beneficiaries |
91 |
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 |
76 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1789 |