National Provider Identifier [NPI]: |
1053391508 |
Last Name Of The Provider |
HUMBLE |
First Name Of The Provider |
BYRON |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1415 N HOUK RD |
Street Address 2 Of The Provider |
SUITE D |
City Of The Provider |
SPOKANE VALLEY |
Zip Code Of The Provider |
992161043 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
103 |
Number Of Services |
888 |
Number Of Medicare Beneficiaries |
132 |
Total Submitted Charge Amount |
294905.62 |
Total Medicare Allowed Amount |
98792.52 |
Total Medicare Payment Amount |
75460.43 |
Total Medicare Standardized Payment Amount |
77140.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
249 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
7383.22 |
Total Drug Medicare AllowedAmount |
3729.8 |
Total Drug Medicare PaymentAmount |
2566.6 |
Total Drug Medicare Standardized Payment Amount |
2566.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
98 |
Number Of Medical Services |
639 |
Number Of Medicare Beneficiaries With Medical Services |
132 |
Total Medical Submitted Charge Amount |
287522.4 |
Total Medical Medicare Allowed Amount |
95062.72 |
Total Medical Medicare Payment Amount |
72893.83 |
Total Medical Medicare Standardized Payment Amount |
74573.87 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
53 |
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 |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1383 |