National Provider Identifier [NPI]: |
1578623088 |
Last Name Of The Provider |
ANOUS |
First Name Of The Provider |
MAHER |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10117 NE 58TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KIRKLAND |
Zip Code Of The Provider |
98033 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
857 |
Number Of Medicare Beneficiaries |
69 |
Total Submitted Charge Amount |
71335 |
Total Medicare Allowed Amount |
41059.18 |
Total Medicare Payment Amount |
31220.33 |
Total Medicare Standardized Payment Amount |
28489.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
210 |
Number Of Medicare Beneficiaries With Drug Services |
50 |
Total Drug Submitted ChargeAmount |
5190 |
Total Drug Medicare AllowedAmount |
2345.23 |
Total Drug Medicare PaymentAmount |
1838.69 |
Total Drug Medicare Standardized Payment Amount |
1838.69 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
647 |
Number Of Medicare Beneficiaries With Medical Services |
69 |
Total Medical Submitted Charge Amount |
66145 |
Total Medical Medicare Allowed Amount |
38713.95 |
Total Medical Medicare Payment Amount |
29381.64 |
Total Medical Medicare Standardized Payment Amount |
26650.99 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
34 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
40 |
Number Of Male Beneficiaries |
29 |
Number Of Non Hispanic White Beneficiaries |
53 |
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 |
|
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
39 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
23 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1707 |