National Provider Identifier [NPI]: |
1861704629 |
Last Name Of The Provider |
BOND |
First Name Of The Provider |
SHANSHAN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1321 COLBY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVERETT |
Zip Code Of The Provider |
982011665 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
645 |
Number Of Medicare Beneficiaries |
249 |
Total Submitted Charge Amount |
131670 |
Total Medicare Allowed Amount |
58393.87 |
Total Medicare Payment Amount |
43897.24 |
Total Medicare Standardized Payment Amount |
44607.56 |
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 |
17 |
Number Of Medical Services |
645 |
Number Of Medicare Beneficiaries With Medical Services |
249 |
Total Medical Submitted Charge Amount |
131670 |
Total Medical Medicare Allowed Amount |
58393.87 |
Total Medical Medicare Payment Amount |
43897.24 |
Total Medical Medicare Standardized Payment Amount |
44607.56 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
217 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
99 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.7759 |