National Provider Identifier [NPI]: |
1972686921 |
Last Name Of The Provider |
PADILLA |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2811 TIETON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
YAKIMA |
Zip Code Of The Provider |
989023761 |
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 |
1422 |
Number Of Medicare Beneficiaries |
905 |
Total Submitted Charge Amount |
317007 |
Total Medicare Allowed Amount |
131201.93 |
Total Medicare Payment Amount |
100890.67 |
Total Medicare Standardized Payment Amount |
103328.29 |
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 |
1422 |
Number Of Medicare Beneficiaries With Medical Services |
905 |
Total Medical Submitted Charge Amount |
317007 |
Total Medical Medicare Allowed Amount |
131201.93 |
Total Medical Medicare Payment Amount |
100890.67 |
Total Medical Medicare Standardized Payment Amount |
103328.29 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
229 |
Number Of Beneficiaries Age 65 to 74 |
240 |
Number Of Beneficiaries Age 75 to 84 |
243 |
Number Of Beneficiaries Age Greater 84 |
193 |
Number Of Female Beneficiaries |
543 |
Number Of Male Beneficiaries |
362 |
Number Of Non Hispanic White Beneficiaries |
751 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
105 |
Number Of American Indian Alaska Native Beneficiaries |
25 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
578 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
327 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5885 |