National Provider Identifier [NPI]: |
1568471282 |
Last Name Of The Provider |
FAGLEY |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
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 |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
363 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
416361 |
Total Medicare Allowed Amount |
97601.59 |
Total Medicare Payment Amount |
76261.9 |
Total Medicare Standardized Payment Amount |
75379.06 |
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 |
72 |
Number Of Medical Services |
363 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
416361 |
Total Medical Medicare Allowed Amount |
97601.59 |
Total Medical Medicare Payment Amount |
76261.9 |
Total Medical Medicare Standardized Payment Amount |
75379.06 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
86 |
Number Of Male Beneficiaries |
110 |
Number Of Non Hispanic White Beneficiaries |
159 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
154 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.356 |