National Provider Identifier [NPI]: |
1184884652 |
Last Name Of The Provider |
KASPROWSKA |
First Name Of The Provider |
MAGDALENA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9290 SE SUNNYBROOK BLVD |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
CLACKAMAS |
Zip Code Of The Provider |
970156899 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
635 |
Number Of Medicare Beneficiaries |
216 |
Total Submitted Charge Amount |
184467 |
Total Medicare Allowed Amount |
60131.27 |
Total Medicare Payment Amount |
40961.43 |
Total Medicare Standardized Payment Amount |
40978.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
36 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1715 |
Total Drug Medicare AllowedAmount |
1093.64 |
Total Drug Medicare PaymentAmount |
1027.7 |
Total Drug Medicare Standardized Payment Amount |
1027.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
599 |
Number Of Medicare Beneficiaries With Medical Services |
216 |
Total Medical Submitted Charge Amount |
182752 |
Total Medical Medicare Allowed Amount |
59037.63 |
Total Medical Medicare Payment Amount |
39933.73 |
Total Medical Medicare Standardized Payment Amount |
39951.23 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
195 |
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 |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1041 |