National Provider Identifier [NPI]: |
1245346758 |
Last Name Of The Provider |
KOCARNIK |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
233 NE 102ND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
97220 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
5190 |
Number Of Medicare Beneficiaries |
1008 |
Total Submitted Charge Amount |
679937.75 |
Total Medicare Allowed Amount |
222900.59 |
Total Medicare Payment Amount |
177565.54 |
Total Medicare Standardized Payment Amount |
174515.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
3455 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
4485.75 |
Total Drug Medicare AllowedAmount |
1071.93 |
Total Drug Medicare PaymentAmount |
814.08 |
Total Drug Medicare Standardized Payment Amount |
814.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
133 |
Number Of Medical Services |
1735 |
Number Of Medicare Beneficiaries With Medical Services |
1008 |
Total Medical Submitted Charge Amount |
675452 |
Total Medical Medicare Allowed Amount |
221828.66 |
Total Medical Medicare Payment Amount |
176751.46 |
Total Medical Medicare Standardized Payment Amount |
173701.48 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
140 |
Number Of Beneficiaries Age 65 to 74 |
500 |
Number Of Beneficiaries Age 75 to 84 |
272 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
769 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
849 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
66 |
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
788 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
220 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1324 |