National Provider Identifier [NPI]: |
1235105180 |
Last Name Of The Provider |
EWASKOW |
First Name Of The Provider |
SANDRA |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1280 116TH AVE NE |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
BELLEVUE |
Zip Code Of The Provider |
980043803 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
463 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
35368 |
Total Medicare Allowed Amount |
19543.49 |
Total Medicare Payment Amount |
15532.86 |
Total Medicare Standardized Payment Amount |
10555.07 |
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 |
463 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
35368 |
Total Medical Medicare Allowed Amount |
19543.49 |
Total Medical Medicare Payment Amount |
15532.86 |
Total Medical Medicare Standardized Payment Amount |
10555.07 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
89 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
166 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
13 |
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
44 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.244 |