National Provider Identifier [NPI]: |
1740216886 |
Last Name Of The Provider |
FARINOLA |
First Name Of The Provider |
MARYAM |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1015 NW 22ND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972103025 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1633 |
Number Of Medicare Beneficiaries |
576 |
Total Submitted Charge Amount |
167992.72 |
Total Medicare Allowed Amount |
78605.7 |
Total Medicare Payment Amount |
59796.47 |
Total Medicare Standardized Payment Amount |
42743.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
1633 |
Number Of Medicare Beneficiaries With Medical Services |
576 |
Total Medical Submitted Charge Amount |
167992.72 |
Total Medical Medicare Allowed Amount |
78605.7 |
Total Medical Medicare Payment Amount |
59796.47 |
Total Medical Medicare Standardized Payment Amount |
42743.28 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
520 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
13 |
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
467 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
109 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
32 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4135 |