National Provider Identifier [NPI]: |
1487767158 |
Last Name Of The Provider |
PARDINI |
First Name Of The Provider |
RICCI |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10180 SE SUNNYSIDE ROAD |
Street Address 2 Of The Provider |
KAISER SUNNYSIDE MEDICAL OFFICE |
City Of The Provider |
CLACKAMAS |
Zip Code Of The Provider |
970159764 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
910 |
Number Of Medicare Beneficiaries |
256 |
Total Submitted Charge Amount |
77548.22 |
Total Medicare Allowed Amount |
25359.61 |
Total Medicare Payment Amount |
19009.14 |
Total Medicare Standardized Payment Amount |
19530.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
20 |
Number Of Drug Services |
258 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
9996.43 |
Total Drug Medicare AllowedAmount |
3866.44 |
Total Drug Medicare PaymentAmount |
3030.71 |
Total Drug Medicare Standardized Payment Amount |
3030.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
652 |
Number Of Medicare Beneficiaries With Medical Services |
256 |
Total Medical Submitted Charge Amount |
67551.79 |
Total Medical Medicare Allowed Amount |
21493.17 |
Total Medical Medicare Payment Amount |
15978.43 |
Total Medical Medicare Standardized Payment Amount |
16499.71 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
93 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
244 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
231 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
37 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3823 |