National Provider Identifier [NPI]: |
1922074160 |
Last Name Of The Provider |
LINDSEY |
First Name Of The Provider |
JUDITH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18010 SW MCEWAN ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE OSWEGO |
Zip Code Of The Provider |
97035 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
673 |
Number Of Medicare Beneficiaries |
160 |
Total Submitted Charge Amount |
142512 |
Total Medicare Allowed Amount |
47577.46 |
Total Medicare Payment Amount |
35107.34 |
Total Medicare Standardized Payment Amount |
34663.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
132 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
3681 |
Total Drug Medicare AllowedAmount |
2446.16 |
Total Drug Medicare PaymentAmount |
2305.78 |
Total Drug Medicare Standardized Payment Amount |
2305.78 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
541 |
Number Of Medicare Beneficiaries With Medical Services |
160 |
Total Medical Submitted Charge Amount |
138831 |
Total Medical Medicare Allowed Amount |
45131.3 |
Total Medical Medicare Payment Amount |
32801.56 |
Total Medical Medicare Standardized Payment Amount |
32358.02 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
143 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1787 |