National Provider Identifier [NPI]: |
1972522019 |
Last Name Of The Provider |
FLEMMER |
First Name Of The Provider |
KRISTEN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 SW BASELINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HILLSBORO |
Zip Code Of The Provider |
971233971 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
213 |
Number Of Medicare Beneficiaries |
48 |
Total Submitted Charge Amount |
48003 |
Total Medicare Allowed Amount |
16879.33 |
Total Medicare Payment Amount |
12567.2 |
Total Medicare Standardized Payment Amount |
12509.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
22 |
Total Drug Submitted ChargeAmount |
1310 |
Total Drug Medicare AllowedAmount |
762.22 |
Total Drug Medicare PaymentAmount |
746.97 |
Total Drug Medicare Standardized Payment Amount |
746.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
191 |
Number Of Medicare Beneficiaries With Medical Services |
48 |
Total Medical Submitted Charge Amount |
46693 |
Total Medical Medicare Allowed Amount |
16117.11 |
Total Medical Medicare Payment Amount |
11820.23 |
Total Medical Medicare Standardized Payment Amount |
11762.44 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
11 |
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 |
35 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8006 |