National Provider Identifier [NPI]: |
1780609743 |
Last Name Of The Provider |
RIES |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2901 SQUALICUM PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLINGHAM |
Zip Code Of The Provider |
982251851 |
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 |
27 |
Number Of Services |
887 |
Number Of Medicare Beneficiaries |
528 |
Total Submitted Charge Amount |
448610 |
Total Medicare Allowed Amount |
95626.83 |
Total Medicare Payment Amount |
73268.71 |
Total Medicare Standardized Payment Amount |
74904.09 |
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 |
27 |
Number Of Medical Services |
887 |
Number Of Medicare Beneficiaries With Medical Services |
528 |
Total Medical Submitted Charge Amount |
448610 |
Total Medical Medicare Allowed Amount |
95626.83 |
Total Medical Medicare Payment Amount |
73268.71 |
Total Medical Medicare Standardized Payment Amount |
74904.09 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
140 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
115 |
Number Of Female Beneficiaries |
276 |
Number Of Male Beneficiaries |
252 |
Number Of Non Hispanic White Beneficiaries |
470 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
15 |
Number Of American Indian Alaska Native Beneficiaries |
21 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
356 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6644 |