National Provider Identifier [NPI]: |
1871694067 |
Last Name Of The Provider |
DELCAMPO |
First Name Of The Provider |
JAIME |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
315 MARTIN LUTHER KING JR WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984054234 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
446 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
198156 |
Total Medicare Allowed Amount |
45859.65 |
Total Medicare Payment Amount |
35680.32 |
Total Medicare Standardized Payment Amount |
36191.82 |
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 |
25 |
Number Of Medical Services |
446 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
198156 |
Total Medical Medicare Allowed Amount |
45859.65 |
Total Medical Medicare Payment Amount |
35680.32 |
Total Medical Medicare Standardized Payment Amount |
36191.82 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
153 |
Number Of Male Beneficiaries |
120 |
Number Of Non Hispanic White Beneficiaries |
224 |
Number Of Black or African American Beneficiaries |
28 |
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 |
172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6286 |