National Provider Identifier [NPI]: |
1902070824 |
Last Name Of The Provider |
VERNON |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
104 W 5TH AVE |
Street Address 2 Of The Provider |
SUITE 400W |
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992044880 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1056 |
Number Of Medicare Beneficiaries |
480 |
Total Submitted Charge Amount |
194165 |
Total Medicare Allowed Amount |
147701.11 |
Total Medicare Payment Amount |
115440.62 |
Total Medicare Standardized Payment Amount |
117157.78 |
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 |
17 |
Number Of Medical Services |
1056 |
Number Of Medicare Beneficiaries With Medical Services |
480 |
Total Medical Submitted Charge Amount |
194165 |
Total Medical Medicare Allowed Amount |
147701.11 |
Total Medical Medicare Payment Amount |
115440.62 |
Total Medical Medicare Standardized Payment Amount |
117157.78 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
122 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
130 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
266 |
Number Of Non Hispanic White Beneficiaries |
441 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
340 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
140 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.4345 |