National Provider Identifier [NPI]: |
1336250752 |
Last Name Of The Provider |
WRIGHT |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD, MS |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1959 NE PACIFIC ST |
Street Address 2 Of The Provider |
BOX 356510 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981950001 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
514 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
428402.26 |
Total Medicare Allowed Amount |
131041.2 |
Total Medicare Payment Amount |
101015.54 |
Total Medicare Standardized Payment Amount |
97086.07 |
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 |
73 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
161 |
Number Of Non Hispanic White Beneficiaries |
164 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
161 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
34 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4167 |