National Provider Identifier [NPI]: |
1275732505 |
Last Name Of The Provider |
JAVERY |
First Name Of The Provider |
OMAR |
Middle Initial Of The Provider |
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Credentials Of The Provider |
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Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 2ND ST NE |
Street Address 2 Of The Provider |
KAISER PERMANENTE CAPITOL HILL MEDICAL CENTER |
City Of The Provider |
WASHINGTON |
Zip Code Of The Provider |
200028100 |
State Code Of The Provider |
DC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
186 |
Number Of Medicare Beneficiaries |
152 |
Total Submitted Charge Amount |
56469.6 |
Total Medicare Allowed Amount |
25384.27 |
Total Medicare Payment Amount |
18424.57 |
Total Medicare Standardized Payment Amount |
17035.65 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
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Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
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Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
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Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
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Number Of Black or African American Beneficiaries |
93 |
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
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Number Of Beneficiaries With Medicare Medicaid Entitlement |
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Percent Of With Atrial Fibrillation |
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Percent Of With Alzheimers Disease or Dementia |
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Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
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Average HCC Risk Score Of Beneficiaries |
1.3785 |