National Provider Identifier [NPI]: |
1548223381 |
Last Name Of The Provider |
ABRAHAM |
First Name Of The Provider |
JACOB |
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 |
9427 SW BARNES ROAD |
Street Address 2 Of The Provider |
SUITE 498 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972256652 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1281 |
Number Of Medicare Beneficiaries |
545 |
Total Submitted Charge Amount |
299377.29 |
Total Medicare Allowed Amount |
85754.25 |
Total Medicare Payment Amount |
65197.92 |
Total Medicare Standardized Payment Amount |
65439.71 |
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 |
47 |
Number Of Medical Services |
1281 |
Number Of Medicare Beneficiaries With Medical Services |
545 |
Total Medical Submitted Charge Amount |
299377.29 |
Total Medical Medicare Allowed Amount |
85754.25 |
Total Medical Medicare Payment Amount |
65197.92 |
Total Medical Medicare Standardized Payment Amount |
65439.71 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
287 |
Number Of Non Hispanic White Beneficiaries |
495 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
23 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
444 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
36 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6624 |