National Provider Identifier [NPI]: |
1821177387 |
Last Name Of The Provider |
EOFF |
First Name Of The Provider |
JANET |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 SW RAMSEY AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRANTS PASS |
Zip Code Of The Provider |
97527 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1017 |
Number Of Medicare Beneficiaries |
649 |
Total Submitted Charge Amount |
396567.21 |
Total Medicare Allowed Amount |
91635.01 |
Total Medicare Payment Amount |
69374.56 |
Total Medicare Standardized Payment Amount |
71525.29 |
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 |
29 |
Number Of Medical Services |
1017 |
Number Of Medicare Beneficiaries With Medical Services |
649 |
Total Medical Submitted Charge Amount |
396567.21 |
Total Medical Medicare Allowed Amount |
91635.01 |
Total Medical Medicare Payment Amount |
69374.56 |
Total Medical Medicare Standardized Payment Amount |
71525.29 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
115 |
Number Of Beneficiaries Age 65 to 74 |
202 |
Number Of Beneficiaries Age 75 to 84 |
187 |
Number Of Beneficiaries Age Greater 84 |
145 |
Number Of Female Beneficiaries |
346 |
Number Of Male Beneficiaries |
303 |
Number Of Non Hispanic White Beneficiaries |
622 |
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 |
455 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
194 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.4141 |