National Provider Identifier [NPI]: |
1730261744 |
Last Name Of The Provider |
PROUDFOOT |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7315 212TH ST SW |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
EDMONDS |
Zip Code Of The Provider |
980267610 |
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 |
121 |
Number Of Services |
1805 |
Number Of Medicare Beneficiaries |
143 |
Total Submitted Charge Amount |
133234 |
Total Medicare Allowed Amount |
76546.67 |
Total Medicare Payment Amount |
57861.58 |
Total Medicare Standardized Payment Amount |
61155.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
59 |
Number Of Medicare Beneficiaries With Drug Services |
49 |
Total Drug Submitted ChargeAmount |
3224 |
Total Drug Medicare AllowedAmount |
2736.66 |
Total Drug Medicare PaymentAmount |
2676.64 |
Total Drug Medicare Standardized Payment Amount |
2676.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
113 |
Number Of Medical Services |
1746 |
Number Of Medicare Beneficiaries With Medical Services |
143 |
Total Medical Submitted Charge Amount |
130010 |
Total Medical Medicare Allowed Amount |
73810.01 |
Total Medical Medicare Payment Amount |
55184.94 |
Total Medical Medicare Standardized Payment Amount |
58478.52 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
69 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
132 |
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 |
11 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
22 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1239 |