National Provider Identifier [NPI]: |
1992004402 |
Last Name Of The Provider |
VASKO |
First Name Of The Provider |
STEPHANIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 NW SAMARITAN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORVALLIS |
Zip Code Of The Provider |
973303737 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
283 |
Number Of Medicare Beneficiaries |
83 |
Total Submitted Charge Amount |
69412 |
Total Medicare Allowed Amount |
26322.32 |
Total Medicare Payment Amount |
20637.19 |
Total Medicare Standardized Payment Amount |
21115.18 |
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 |
13 |
Number Of Medical Services |
283 |
Number Of Medicare Beneficiaries With Medical Services |
83 |
Total Medical Submitted Charge Amount |
69412 |
Total Medical Medicare Allowed Amount |
26322.32 |
Total Medical Medicare Payment Amount |
20637.19 |
Total Medical Medicare Standardized Payment Amount |
21115.18 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
28 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
41 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
61 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9442 |