National Provider Identifier [NPI]: |
1518063288 |
Last Name Of The Provider |
LOERA |
First Name Of The Provider |
JOSE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 S AUBURN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
KENNEWICK |
Zip Code Of The Provider |
993365621 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1309 |
Number Of Medicare Beneficiaries |
770 |
Total Submitted Charge Amount |
386606 |
Total Medicare Allowed Amount |
147530.66 |
Total Medicare Payment Amount |
107742.6 |
Total Medicare Standardized Payment Amount |
111829.97 |
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 |
39 |
Number Of Medical Services |
1309 |
Number Of Medicare Beneficiaries With Medical Services |
770 |
Total Medical Submitted Charge Amount |
386606 |
Total Medical Medicare Allowed Amount |
147530.66 |
Total Medical Medicare Payment Amount |
107742.6 |
Total Medical Medicare Standardized Payment Amount |
111829.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
215 |
Number Of Beneficiaries Age 75 to 84 |
208 |
Number Of Beneficiaries Age Greater 84 |
164 |
Number Of Female Beneficiaries |
475 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
660 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
75 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
511 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
259 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8098 |