National Provider Identifier [NPI]: |
1003836487 |
Last Name Of The Provider |
VINSON |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5050 NE HOYT ST |
Street Address 2 Of The Provider |
STE 454 |
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
972132991 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
241 |
Number Of Medicare Beneficiaries |
92 |
Total Submitted Charge Amount |
44226 |
Total Medicare Allowed Amount |
15110.8 |
Total Medicare Payment Amount |
10496.53 |
Total Medicare Standardized Payment Amount |
10758.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
41 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
2104 |
Total Drug Medicare AllowedAmount |
1339.44 |
Total Drug Medicare PaymentAmount |
1158.83 |
Total Drug Medicare Standardized Payment Amount |
1158.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
200 |
Number Of Medicare Beneficiaries With Medical Services |
92 |
Total Medical Submitted Charge Amount |
42122 |
Total Medical Medicare Allowed Amount |
13771.36 |
Total Medical Medicare Payment Amount |
9337.7 |
Total Medical Medicare Standardized Payment Amount |
9599.99 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
42 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
78 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
68 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9705 |