National Provider Identifier [NPI]: |
1295738821 |
Last Name Of The Provider |
LANIER |
First Name Of The Provider |
KEITH |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9135 SW BARNES RD |
Street Address 2 Of The Provider |
STE 261 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972256601 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
5664 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
328370 |
Total Medicare Allowed Amount |
171778.64 |
Total Medicare Payment Amount |
132551.91 |
Total Medicare Standardized Payment Amount |
131843.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
30 |
Number Of Drug Services |
4881 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
194366 |
Total Drug Medicare AllowedAmount |
129207.85 |
Total Drug Medicare PaymentAmount |
101223.29 |
Total Drug Medicare Standardized Payment Amount |
101223.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
783 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
134004 |
Total Medical Medicare Allowed Amount |
42570.79 |
Total Medical Medicare Payment Amount |
31328.62 |
Total Medical Medicare Standardized Payment Amount |
30619.8 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
35 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4371 |