National Provider Identifier [NPI]: |
1780786756 |
Last Name Of The Provider |
KRAVETTE |
First Name Of The Provider |
MARC |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 9TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981012756 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
687 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
188667.26 |
Total Medicare Allowed Amount |
62512.85 |
Total Medicare Payment Amount |
45995.89 |
Total Medicare Standardized Payment Amount |
46093.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
53 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
401.76 |
Total Drug Medicare AllowedAmount |
101.57 |
Total Drug Medicare PaymentAmount |
82.6 |
Total Drug Medicare Standardized Payment Amount |
82.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
634 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
188265.5 |
Total Medical Medicare Allowed Amount |
62411.28 |
Total Medical Medicare Payment Amount |
45913.29 |
Total Medical Medicare Standardized Payment Amount |
46010.46 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
152 |
Number Of Male Beneficiaries |
90 |
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 |
226 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0924 |