National Provider Identifier [NPI]: |
1508830621 |
Last Name Of The Provider |
MCANINCH |
First Name Of The Provider |
MALCOLM |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9450 SW BARNES RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972256619 |
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 |
24 |
Number Of Services |
360 |
Number Of Medicare Beneficiaries |
103 |
Total Submitted Charge Amount |
66673 |
Total Medicare Allowed Amount |
30264.31 |
Total Medicare Payment Amount |
24327.51 |
Total Medicare Standardized Payment Amount |
24353.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
56 |
Number Of Medicare Beneficiaries With Drug Services |
46 |
Total Drug Submitted ChargeAmount |
4450 |
Total Drug Medicare AllowedAmount |
3814.06 |
Total Drug Medicare PaymentAmount |
3571.73 |
Total Drug Medicare Standardized Payment Amount |
3571.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
304 |
Number Of Medicare Beneficiaries With Medical Services |
103 |
Total Medical Submitted Charge Amount |
62223 |
Total Medical Medicare Allowed Amount |
26450.25 |
Total Medical Medicare Payment Amount |
20755.78 |
Total Medical Medicare Standardized Payment Amount |
20781.53 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
33 |
Number Of Male Beneficiaries |
70 |
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 |
14 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
30 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
20 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7955 |