National Provider Identifier [NPI]: |
1225058035 |
Last Name Of The Provider |
LUND |
First Name Of The Provider |
JESSICA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3927 RUCKER AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVERETT |
Zip Code Of The Provider |
982014833 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
771 |
Number Of Medicare Beneficiaries |
212 |
Total Submitted Charge Amount |
139465.5 |
Total Medicare Allowed Amount |
57672.5 |
Total Medicare Payment Amount |
40437.65 |
Total Medicare Standardized Payment Amount |
42565.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
78.25 |
Total Drug Medicare AllowedAmount |
35.11 |
Total Drug Medicare PaymentAmount |
26.1 |
Total Drug Medicare Standardized Payment Amount |
26.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
755 |
Number Of Medicare Beneficiaries With Medical Services |
212 |
Total Medical Submitted Charge Amount |
139387.25 |
Total Medical Medicare Allowed Amount |
57637.39 |
Total Medical Medicare Payment Amount |
40411.55 |
Total Medical Medicare Standardized Payment Amount |
42539.52 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
85 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
136 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
196 |
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4532 |