National Provider Identifier [NPI]: |
1942259478 |
Last Name Of The Provider |
CHILSON |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
122 W 7TH AVE |
Street Address 2 Of The Provider |
STE #450 |
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
99204 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
3481 |
Number Of Medicare Beneficiaries |
668 |
Total Submitted Charge Amount |
745709 |
Total Medicare Allowed Amount |
323378.3 |
Total Medicare Payment Amount |
242862.34 |
Total Medicare Standardized Payment Amount |
254784.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
3481 |
Number Of Medicare Beneficiaries With Medical Services |
668 |
Total Medical Submitted Charge Amount |
745709 |
Total Medical Medicare Allowed Amount |
323378.3 |
Total Medical Medicare Payment Amount |
242862.34 |
Total Medical Medicare Standardized Payment Amount |
254784.09 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
260 |
Number Of Beneficiaries Age 75 to 84 |
244 |
Number Of Beneficiaries Age Greater 84 |
111 |
Number Of Female Beneficiaries |
255 |
Number Of Male Beneficiaries |
413 |
Number Of Non Hispanic White Beneficiaries |
635 |
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 |
583 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
43 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.722 |