National Provider Identifier [NPI]: |
1730181512 |
Last Name Of The Provider |
MICHALSON |
First Name Of The Provider |
LINDA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 W IRONWOOD DR |
Street Address 2 Of The Provider |
SUITE 110 |
City Of The Provider |
COEUR D ALENE |
Zip Code Of The Provider |
838142656 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
154 |
Number Of Services |
2453 |
Number Of Medicare Beneficiaries |
1555 |
Total Submitted Charge Amount |
262018 |
Total Medicare Allowed Amount |
73139.95 |
Total Medicare Payment Amount |
56088.59 |
Total Medicare Standardized Payment Amount |
59696.81 |
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 |
154 |
Number Of Medical Services |
2453 |
Number Of Medicare Beneficiaries With Medical Services |
1555 |
Total Medical Submitted Charge Amount |
262018 |
Total Medical Medicare Allowed Amount |
73139.95 |
Total Medical Medicare Payment Amount |
56088.59 |
Total Medical Medicare Standardized Payment Amount |
59696.81 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
256 |
Number Of Beneficiaries Age 65 to 74 |
689 |
Number Of Beneficiaries Age 75 to 84 |
437 |
Number Of Beneficiaries Age Greater 84 |
173 |
Number Of Female Beneficiaries |
1068 |
Number Of Male Beneficiaries |
487 |
Number Of Non Hispanic White Beneficiaries |
1502 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
20 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1204 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
351 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3589 |