| National Provider Identifier [NPI]: | 1588942155 |
| Last Name Of The Provider | BAGARES |
| First Name Of The Provider | FREDERICK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 NE MOTHER JOSEPH PL |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | VANCOUVER |
| Zip Code Of The Provider | 986643299 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1597 |
| Number Of Medicare Beneficiaries | 335 |
| Total Submitted Charge Amount | 319110.31 |
| Total Medicare Allowed Amount | 107277.47 |
| Total Medicare Payment Amount | 79097.29 |
| Total Medicare Standardized Payment Amount | 76783.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 388 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 1589.65 |
| Total Drug Medicare AllowedAmount | 721.81 |
| Total Drug Medicare PaymentAmount | 537.36 |
| Total Drug Medicare Standardized Payment Amount | 537.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 1209 |
| Number Of Medicare Beneficiaries With Medical Services | 333 |
| Total Medical Submitted Charge Amount | 317520.66 |
| Total Medical Medicare Allowed Amount | 106555.66 |
| Total Medical Medicare Payment Amount | 78559.93 |
| Total Medical Medicare Standardized Payment Amount | 76245.96 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 311 |
| 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 | 258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9816 |