National Provider Identifier [NPI]: |
1902832363 |
Last Name Of The Provider |
HUNGERFORD |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1321 NE 99TH AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972209436 |
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 |
42 |
Number Of Services |
465 |
Number Of Medicare Beneficiaries |
152 |
Total Submitted Charge Amount |
113611 |
Total Medicare Allowed Amount |
37182.07 |
Total Medicare Payment Amount |
26244.31 |
Total Medicare Standardized Payment Amount |
26438.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
83 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1225 |
Total Drug Medicare AllowedAmount |
761.79 |
Total Drug Medicare PaymentAmount |
671.06 |
Total Drug Medicare Standardized Payment Amount |
671.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
382 |
Number Of Medicare Beneficiaries With Medical Services |
152 |
Total Medical Submitted Charge Amount |
112386 |
Total Medical Medicare Allowed Amount |
36420.28 |
Total Medical Medicare Payment Amount |
25573.25 |
Total Medical Medicare Standardized Payment Amount |
25767.29 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
141 |
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 |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
27 |
Percent Of With Hypertension |
41 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9031 |