National Provider Identifier [NPI]: |
1780997783 |
Last Name Of The Provider |
ORAMAS |
First Name Of The Provider |
EMPRESS |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2555 MARVIN RD NE |
Street Address 2 Of The Provider |
PMG SW WA HAWKS PRAIRIE FM |
City Of The Provider |
LACEY |
Zip Code Of The Provider |
985163138 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
517 |
Number Of Medicare Beneficiaries |
119 |
Total Submitted Charge Amount |
99741 |
Total Medicare Allowed Amount |
43449.11 |
Total Medicare Payment Amount |
31399.46 |
Total Medicare Standardized Payment Amount |
31627.37 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
52 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
1666 |
Total Drug Medicare AllowedAmount |
1089.48 |
Total Drug Medicare PaymentAmount |
1057.97 |
Total Drug Medicare Standardized Payment Amount |
1057.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
465 |
Number Of Medicare Beneficiaries With Medical Services |
118 |
Total Medical Submitted Charge Amount |
98075 |
Total Medical Medicare Allowed Amount |
42359.63 |
Total Medical Medicare Payment Amount |
30341.49 |
Total Medical Medicare Standardized Payment Amount |
30569.4 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
61 |
Number Of Beneficiaries Age 75 to 84 |
17 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
73 |
Number Of Male Beneficiaries |
46 |
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1006 |