National Provider Identifier [NPI]: |
1588678999 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 W POPLAR ST |
Street Address 2 Of The Provider |
PSMMC ER |
City Of The Provider |
WALLA WALLA |
Zip Code Of The Provider |
993622846 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
480 |
Number Of Medicare Beneficiaries |
401 |
Total Submitted Charge Amount |
133687 |
Total Medicare Allowed Amount |
54047.47 |
Total Medicare Payment Amount |
41281.45 |
Total Medicare Standardized Payment Amount |
42339.86 |
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 |
23 |
Number Of Medical Services |
480 |
Number Of Medicare Beneficiaries With Medical Services |
401 |
Total Medical Submitted Charge Amount |
133687 |
Total Medical Medicare Allowed Amount |
54047.47 |
Total Medical Medicare Payment Amount |
41281.45 |
Total Medical Medicare Standardized Payment Amount |
42339.86 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
223 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
372 |
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 |
290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.658 |