National Provider Identifier [NPI]: |
1124071592 |
Last Name Of The Provider |
MARTINCIC |
First Name Of The Provider |
DANKO |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12615 E MISSION AVE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SPOKANE VALLEY |
Zip Code Of The Provider |
992161047 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
192203 |
Number Of Medicare Beneficiaries |
700 |
Total Submitted Charge Amount |
10033388.17 |
Total Medicare Allowed Amount |
3146257.46 |
Total Medicare Payment Amount |
2427343.76 |
Total Medicare Standardized Payment Amount |
2422789.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
73 |
Number Of Drug Services |
179415 |
Number Of Medicare Beneficiaries With Drug Services |
272 |
Total Drug Submitted ChargeAmount |
8184481.17 |
Total Drug Medicare AllowedAmount |
2516322.36 |
Total Drug Medicare PaymentAmount |
1940457.47 |
Total Drug Medicare Standardized Payment Amount |
1940457.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
65 |
Number Of Medical Services |
12788 |
Number Of Medicare Beneficiaries With Medical Services |
700 |
Total Medical Submitted Charge Amount |
1848907 |
Total Medical Medicare Allowed Amount |
629935.1 |
Total Medical Medicare Payment Amount |
486886.29 |
Total Medical Medicare Standardized Payment Amount |
482332.17 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
224 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
416 |
Number Of Male Beneficiaries |
284 |
Number Of Non Hispanic White Beneficiaries |
665 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
615 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
42 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.806 |