National Provider Identifier [NPI]: |
1285743641 |
Last Name Of The Provider |
MCGOODWIN |
First Name Of The Provider |
WENDY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
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 |
Hospice and Palliative Care |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
534 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
123643 |
Total Medicare Allowed Amount |
54790.36 |
Total Medicare Payment Amount |
41846.19 |
Total Medicare Standardized Payment Amount |
43031.07 |
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 |
18 |
Number Of Medical Services |
534 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
123643 |
Total Medical Medicare Allowed Amount |
54790.36 |
Total Medical Medicare Payment Amount |
41846.19 |
Total Medical Medicare Standardized Payment Amount |
43031.07 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
103 |
Number Of Male Beneficiaries |
116 |
Number Of Non Hispanic White Beneficiaries |
192 |
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 |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.5268 |