National Provider Identifier [NPI]: |
1205912920 |
Last Name Of The Provider |
HAWN |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
HARBORVIEW MEDICAL CENTER |
Street Address 2 Of The Provider |
325 9TH AVE |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
98104 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
214 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
41488.7 |
Total Medicare Allowed Amount |
20171.91 |
Total Medicare Payment Amount |
15202.08 |
Total Medicare Standardized Payment Amount |
14601.9 |
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 |
214 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
41488.7 |
Total Medical Medicare Allowed Amount |
20171.91 |
Total Medical Medicare Payment Amount |
15202.08 |
Total Medical Medicare Standardized Payment Amount |
14601.9 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
65 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
13 |
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 |
67 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.8271 |