National Provider Identifier [NPI]: |
1053413153 |
Last Name Of The Provider |
PHANEUF |
First Name Of The Provider |
JOSEPH |
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 |
101 W 8TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992042307 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1164 |
Number Of Medicare Beneficiaries |
471 |
Total Submitted Charge Amount |
288669.5 |
Total Medicare Allowed Amount |
123164.33 |
Total Medicare Payment Amount |
93982.5 |
Total Medicare Standardized Payment Amount |
95407.78 |
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 |
19 |
Number Of Medical Services |
1164 |
Number Of Medicare Beneficiaries With Medical Services |
471 |
Total Medical Submitted Charge Amount |
288669.5 |
Total Medical Medicare Allowed Amount |
123164.33 |
Total Medical Medicare Payment Amount |
93982.5 |
Total Medical Medicare Standardized Payment Amount |
95407.78 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
253 |
Number Of Male Beneficiaries |
218 |
Number Of Non Hispanic White Beneficiaries |
422 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.1668 |