| National Provider Identifier [NPI]: | 1477629509 |
| Last Name Of The Provider | PUTERBAUGH |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9155 SW BARNES RD |
| Street Address 2 Of The Provider | SUITE 422 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972256625 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1101 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 51158.07 |
| Total Medicare Allowed Amount | 44180.68 |
| Total Medicare Payment Amount | 30144.39 |
| Total Medicare Standardized Payment Amount | 31824.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 1683.5 |
| Total Drug Medicare AllowedAmount | 1368.82 |
| Total Drug Medicare PaymentAmount | 1308.26 |
| Total Drug Medicare Standardized Payment Amount | 1308.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1023 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 49474.57 |
| Total Medical Medicare Allowed Amount | 42811.86 |
| Total Medical Medicare Payment Amount | 28836.13 |
| Total Medical Medicare Standardized Payment Amount | 30516.35 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 82 |
| 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 | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.7454 |