National Provider Identifier [NPI]: |
1700888435 |
Last Name Of The Provider |
BRAY |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
510 S COWLEY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992021332 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
2246 |
Number Of Medicare Beneficiaries |
861 |
Total Submitted Charge Amount |
700810.24 |
Total Medicare Allowed Amount |
292508.41 |
Total Medicare Payment Amount |
207572.25 |
Total Medicare Standardized Payment Amount |
213024.36 |
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 |
53 |
Number Of Medical Services |
2246 |
Number Of Medicare Beneficiaries With Medical Services |
861 |
Total Medical Submitted Charge Amount |
700810.24 |
Total Medical Medicare Allowed Amount |
292508.41 |
Total Medical Medicare Payment Amount |
207572.25 |
Total Medical Medicare Standardized Payment Amount |
213024.36 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
301 |
Number Of Beneficiaries Age 75 to 84 |
363 |
Number Of Beneficiaries Age Greater 84 |
163 |
Number Of Female Beneficiaries |
510 |
Number Of Male Beneficiaries |
351 |
Number Of Non Hispanic White Beneficiaries |
803 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
801 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1143 |