National Provider Identifier [NPI]: |
1316959646 |
Last Name Of The Provider |
KANTOROWITZ |
First Name Of The Provider |
DAVID |
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 |
307 S 13TH ST STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOUNT VERNON |
Zip Code Of The Provider |
982744100 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
2872 |
Number Of Medicare Beneficiaries |
320 |
Total Submitted Charge Amount |
1102582.57 |
Total Medicare Allowed Amount |
267467.84 |
Total Medicare Payment Amount |
207285.91 |
Total Medicare Standardized Payment Amount |
198923.43 |
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 |
30 |
Number Of Medical Services |
2872 |
Number Of Medicare Beneficiaries With Medical Services |
320 |
Total Medical Submitted Charge Amount |
1102582.57 |
Total Medical Medicare Allowed Amount |
267467.84 |
Total Medical Medicare Payment Amount |
207285.91 |
Total Medical Medicare Standardized Payment Amount |
198923.43 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
160 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
295 |
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 |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
72 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.517 |