National Provider Identifier [NPI]: |
1427251008 |
Last Name Of The Provider |
EVERETT |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10531 CONSTITUTION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANCHORAGE |
Zip Code Of The Provider |
995152511 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
211 |
Number Of Medicare Beneficiaries |
135 |
Total Submitted Charge Amount |
192044 |
Total Medicare Allowed Amount |
28797.54 |
Total Medicare Payment Amount |
22124.53 |
Total Medicare Standardized Payment Amount |
15958.41 |
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 |
13 |
Number Of Medical Services |
211 |
Number Of Medicare Beneficiaries With Medical Services |
135 |
Total Medical Submitted Charge Amount |
192044 |
Total Medical Medicare Allowed Amount |
28797.54 |
Total Medical Medicare Payment Amount |
22124.53 |
Total Medical Medicare Standardized Payment Amount |
15958.41 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
0 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
135 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
56 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
24 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4929 |