National Provider Identifier [NPI]: |
1255436481 |
Last Name Of The Provider |
HART |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1321 COLBY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVERETT |
Zip Code Of The Provider |
982011665 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
450 |
Number Of Medicare Beneficiaries |
245 |
Total Submitted Charge Amount |
99122 |
Total Medicare Allowed Amount |
43920.18 |
Total Medicare Payment Amount |
33660.59 |
Total Medicare Standardized Payment Amount |
34257.91 |
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 |
17 |
Number Of Medical Services |
450 |
Number Of Medicare Beneficiaries With Medical Services |
245 |
Total Medical Submitted Charge Amount |
99122 |
Total Medical Medicare Allowed Amount |
43920.18 |
Total Medical Medicare Payment Amount |
33660.59 |
Total Medical Medicare Standardized Payment Amount |
34257.91 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
221 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.6304 |