National Provider Identifier [NPI]: |
1588673073 |
Last Name Of The Provider |
TAYLOR |
First Name Of The Provider |
STEVE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1420 AHTANUM RIDGE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
UNION GAP |
Zip Code Of The Provider |
989031839 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
1231 |
Number Of Medicare Beneficiaries |
113 |
Total Submitted Charge Amount |
134706.38 |
Total Medicare Allowed Amount |
53556.78 |
Total Medicare Payment Amount |
33079.43 |
Total Medicare Standardized Payment Amount |
36441.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
144 |
Number Of Medicare Beneficiaries With Drug Services |
34 |
Total Drug Submitted ChargeAmount |
2059.05 |
Total Drug Medicare AllowedAmount |
665.29 |
Total Drug Medicare PaymentAmount |
599.88 |
Total Drug Medicare Standardized Payment Amount |
599.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
1087 |
Number Of Medicare Beneficiaries With Medical Services |
113 |
Total Medical Submitted Charge Amount |
132647.33 |
Total Medical Medicare Allowed Amount |
52891.49 |
Total Medical Medicare Payment Amount |
32479.55 |
Total Medical Medicare Standardized Payment Amount |
35842.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
68 |
Number Of Male Beneficiaries |
45 |
Number Of Non Hispanic White Beneficiaries |
82 |
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 |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
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 |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8255 |