National Provider Identifier [NPI]: |
1801804380 |
Last Name Of The Provider |
GIRARD |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3181 SW SAM JACKSON PARK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972393011 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
359 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
24329 |
Total Medicare Allowed Amount |
20903.33 |
Total Medicare Payment Amount |
14695.68 |
Total Medicare Standardized Payment Amount |
14789.68 |
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 |
9 |
Number Of Medical Services |
359 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
24329 |
Total Medical Medicare Allowed Amount |
20903.33 |
Total Medical Medicare Payment Amount |
14695.68 |
Total Medical Medicare Standardized Payment Amount |
14789.68 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
126 |
Number Of Non Hispanic White Beneficiaries |
219 |
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 |
210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3714 |