National Provider Identifier [NPI]: |
1366879280 |
Last Name Of The Provider |
BIJLANI |
First Name Of The Provider |
ROMILLA |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3181 SW SAM JACKSON PARK RD |
Street Address 2 Of The Provider |
DEPT OF OTOLARYNGOLOGY/HEAD & NECK SURGERY, PV01 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972393011 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
97 |
Number Of Medicare Beneficiaries |
47 |
Total Submitted Charge Amount |
13451.75 |
Total Medicare Allowed Amount |
4447.1 |
Total Medicare Payment Amount |
3316.68 |
Total Medicare Standardized Payment Amount |
3912.98 |
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 |
15 |
Number Of Medical Services |
97 |
Number Of Medicare Beneficiaries With Medical Services |
47 |
Total Medical Submitted Charge Amount |
13451.75 |
Total Medical Medicare Allowed Amount |
4447.1 |
Total Medical Medicare Payment Amount |
3316.68 |
Total Medical Medicare Standardized Payment Amount |
3912.98 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
18 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
15 |
Number Of Male Beneficiaries |
32 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
51 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.2273 |