National Provider Identifier [NPI]: |
1184699746 |
Last Name Of The Provider |
RUNDLE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3200 MAIN STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
VANCOUVER |
Zip Code Of The Provider |
98663 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1409 |
Number Of Medicare Beneficiaries |
784 |
Total Submitted Charge Amount |
304110 |
Total Medicare Allowed Amount |
144106.02 |
Total Medicare Payment Amount |
95279.38 |
Total Medicare Standardized Payment Amount |
96046.29 |
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 |
27 |
Number Of Medical Services |
1409 |
Number Of Medicare Beneficiaries With Medical Services |
784 |
Total Medical Submitted Charge Amount |
304110 |
Total Medical Medicare Allowed Amount |
144106.02 |
Total Medical Medicare Payment Amount |
95279.38 |
Total Medical Medicare Standardized Payment Amount |
96046.29 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
280 |
Number Of Beneficiaries Age 75 to 84 |
282 |
Number Of Beneficiaries Age Greater 84 |
169 |
Number Of Female Beneficiaries |
509 |
Number Of Male Beneficiaries |
275 |
Number Of Non Hispanic White Beneficiaries |
736 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
18 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
15 |
Number Of Beneficiaries With Medicare Only Entitlement |
659 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.132 |