National Provider Identifier [NPI]: |
1164680344 |
Last Name Of The Provider |
MANN |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
533 S 336TH ST |
Street Address 2 Of The Provider |
STE C |
City Of The Provider |
FEDERAL WAY |
Zip Code Of The Provider |
980036329 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
1911 |
Number Of Medicare Beneficiaries |
1081 |
Total Submitted Charge Amount |
141796.65 |
Total Medicare Allowed Amount |
44171.33 |
Total Medicare Payment Amount |
35313.81 |
Total Medicare Standardized Payment Amount |
34125.36 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
160 |
Number Of Beneficiaries Age 65 to 74 |
474 |
Number Of Beneficiaries Age 75 to 84 |
338 |
Number Of Beneficiaries Age Greater 84 |
109 |
Number Of Female Beneficiaries |
790 |
Number Of Male Beneficiaries |
291 |
Number Of Non Hispanic White Beneficiaries |
831 |
Number Of Black or African American Beneficiaries |
101 |
Number Of AsianPacific Islander Beneficiaries |
74 |
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
794 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.4607 |