National Provider Identifier [NPI]: |
1962447730 |
Last Name Of The Provider |
SEETO |
First Name Of The Provider |
KEIFONG |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
960 LIBERTY ST SE |
Street Address 2 Of The Provider |
SUITE 140 |
City Of The Provider |
SALEM |
Zip Code Of The Provider |
973024165 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
666 |
Number Of Medicare Beneficiaries |
315 |
Total Submitted Charge Amount |
212827 |
Total Medicare Allowed Amount |
75984.15 |
Total Medicare Payment Amount |
54582.64 |
Total Medicare Standardized Payment Amount |
57244.54 |
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 |
21 |
Number Of Medical Services |
666 |
Number Of Medicare Beneficiaries With Medical Services |
315 |
Total Medical Submitted Charge Amount |
212827 |
Total Medical Medicare Allowed Amount |
75984.15 |
Total Medical Medicare Payment Amount |
54582.64 |
Total Medical Medicare Standardized Payment Amount |
57244.54 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
177 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
276 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
197 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5668 |