National Provider Identifier [NPI]: |
1013969856 |
Last Name Of The Provider |
GREGORY |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
922 S 348TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FEDERAL WAY |
Zip Code Of The Provider |
980037021 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
6448 |
Number Of Medicare Beneficiaries |
418 |
Total Submitted Charge Amount |
5449571.24 |
Total Medicare Allowed Amount |
1763710.88 |
Total Medicare Payment Amount |
1362915.62 |
Total Medicare Standardized Payment Amount |
1167325.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
3939 |
Number Of Medicare Beneficiaries With Drug Services |
124 |
Total Drug Submitted ChargeAmount |
17839.49 |
Total Drug Medicare AllowedAmount |
11894.44 |
Total Drug Medicare PaymentAmount |
9325.09 |
Total Drug Medicare Standardized Payment Amount |
9325.09 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
2509 |
Number Of Medicare Beneficiaries With Medical Services |
418 |
Total Medical Submitted Charge Amount |
5431731.75 |
Total Medical Medicare Allowed Amount |
1751816.44 |
Total Medical Medicare Payment Amount |
1353590.53 |
Total Medical Medicare Standardized Payment Amount |
1158000.32 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
194 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
86 |
Number Of AsianPacific Islander Beneficiaries |
61 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
196 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
64 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
7.4656 |