National Provider Identifier [NPI]: |
1164714671 |
Last Name Of The Provider |
MAY |
First Name Of The Provider |
SARA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 NE GILMAN BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ISSAQUAH |
Zip Code Of The Provider |
980272925 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
159 |
Number Of Medicare Beneficiaries |
85 |
Total Submitted Charge Amount |
27281.05 |
Total Medicare Allowed Amount |
10190.21 |
Total Medicare Payment Amount |
7983.56 |
Total Medicare Standardized Payment Amount |
7575.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
13 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
511.05 |
Total Drug Medicare AllowedAmount |
343 |
Total Drug Medicare PaymentAmount |
335.76 |
Total Drug Medicare Standardized Payment Amount |
335.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
146 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
26770 |
Total Medical Medicare Allowed Amount |
9847.21 |
Total Medical Medicare Payment Amount |
7647.8 |
Total Medical Medicare Standardized Payment Amount |
7239.55 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
20 |
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 |
18 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
14 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
42 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0169 |