National Provider Identifier [NPI]: |
1265409155 |
Last Name Of The Provider |
GOEKE |
First Name Of The Provider |
JAMES |
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 |
707 SW WASHINGTON ST |
Street Address 2 Of The Provider |
SUITE 700 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972053536 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
133 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
158010 |
Total Medicare Allowed Amount |
27728.38 |
Total Medicare Payment Amount |
21371.99 |
Total Medicare Standardized Payment Amount |
22497.21 |
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 |
45 |
Number Of Medical Services |
133 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
158010 |
Total Medical Medicare Allowed Amount |
27728.38 |
Total Medical Medicare Payment Amount |
21371.99 |
Total Medical Medicare Standardized Payment Amount |
22497.21 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
93 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
77 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
16 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.467 |