National Provider Identifier [NPI]: |
1619906328 |
Last Name Of The Provider |
PEPPER |
First Name Of The Provider |
DANIEL |
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 |
1135 116TH AVE NE |
Street Address 2 Of The Provider |
SUITE 305 |
City Of The Provider |
BELLEVUE |
Zip Code Of The Provider |
980044623 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
693 |
Number Of Medicare Beneficiaries |
305 |
Total Submitted Charge Amount |
462274.8 |
Total Medicare Allowed Amount |
155122.15 |
Total Medicare Payment Amount |
117143.13 |
Total Medicare Standardized Payment Amount |
107114.05 |
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 |
62 |
Number Of Medical Services |
693 |
Number Of Medicare Beneficiaries With Medical Services |
305 |
Total Medical Submitted Charge Amount |
462274.8 |
Total Medical Medicare Allowed Amount |
155122.15 |
Total Medical Medicare Payment Amount |
117143.13 |
Total Medical Medicare Standardized Payment Amount |
107114.05 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
179 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
289 |
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 |
281 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3843 |