National Provider Identifier [NPI]: |
1740350727 |
Last Name Of The Provider |
SWEENEY |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
315 MARTIN LUTHER KING JR WAY |
Street Address 2 Of The Provider |
TACOMA GENERAL HOSPITAL |
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984054234 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
733 |
Number Of Medicare Beneficiaries |
440 |
Total Submitted Charge Amount |
324247 |
Total Medicare Allowed Amount |
74567.61 |
Total Medicare Payment Amount |
57992.26 |
Total Medicare Standardized Payment Amount |
58779.82 |
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 |
25 |
Number Of Medical Services |
733 |
Number Of Medicare Beneficiaries With Medical Services |
440 |
Total Medical Submitted Charge Amount |
324247 |
Total Medical Medicare Allowed Amount |
74567.61 |
Total Medical Medicare Payment Amount |
57992.26 |
Total Medical Medicare Standardized Payment Amount |
58779.82 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
131 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
265 |
Number Of Male Beneficiaries |
175 |
Number Of Non Hispanic White Beneficiaries |
338 |
Number Of Black or African American Beneficiaries |
45 |
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
271 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
169 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8388 |