National Provider Identifier [NPI]: |
1639170152 |
Last Name Of The Provider |
KREMER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3260 NW VINTAGE WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
SILVERDALE |
Zip Code Of The Provider |
983836000 |
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 |
45 |
Number Of Services |
3717 |
Number Of Medicare Beneficiaries |
1225 |
Total Submitted Charge Amount |
1261902 |
Total Medicare Allowed Amount |
617059.91 |
Total Medicare Payment Amount |
448477.91 |
Total Medicare Standardized Payment Amount |
457708.71 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
524 |
Number Of Beneficiaries Age 75 to 84 |
404 |
Number Of Beneficiaries Age Greater 84 |
251 |
Number Of Female Beneficiaries |
748 |
Number Of Male Beneficiaries |
477 |
Number Of Non Hispanic White Beneficiaries |
1141 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
1156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
69 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9942 |