National Provider Identifier [NPI]: |
1972541167 |
Last Name Of The Provider |
HANLEY |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 NE 92ND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
VANCOUVER |
Zip Code Of The Provider |
986643225 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
424 |
Number Of Medicare Beneficiaries |
307 |
Total Submitted Charge Amount |
117819 |
Total Medicare Allowed Amount |
32340.43 |
Total Medicare Payment Amount |
24765.22 |
Total Medicare Standardized Payment Amount |
24910.76 |
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 |
15 |
Number Of Medical Services |
424 |
Number Of Medicare Beneficiaries With Medical Services |
307 |
Total Medical Submitted Charge Amount |
117819 |
Total Medical Medicare Allowed Amount |
32340.43 |
Total Medical Medicare Payment Amount |
24765.22 |
Total Medical Medicare Standardized Payment Amount |
24910.76 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
146 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.9259 |