National Provider Identifier [NPI]: |
1396743043 |
Last Name Of The Provider |
LITTLE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13102 E MISSION AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE VALLEY |
Zip Code Of The Provider |
992162710 |
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 |
59 |
Number Of Services |
2375 |
Number Of Medicare Beneficiaries |
221 |
Total Submitted Charge Amount |
218156 |
Total Medicare Allowed Amount |
93723.77 |
Total Medicare Payment Amount |
67354.37 |
Total Medicare Standardized Payment Amount |
68801.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1857 |
Total Drug Medicare AllowedAmount |
1418.52 |
Total Drug Medicare PaymentAmount |
1385.07 |
Total Drug Medicare Standardized Payment Amount |
1385.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
2336 |
Number Of Medicare Beneficiaries With Medical Services |
221 |
Total Medical Submitted Charge Amount |
216299 |
Total Medical Medicare Allowed Amount |
92305.25 |
Total Medical Medicare Payment Amount |
65969.3 |
Total Medical Medicare Standardized Payment Amount |
67416.33 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
82 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
111 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.092 |