National Provider Identifier [NPI]: |
1215080379 |
Last Name Of The Provider |
BERMAN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
406 S 30TH AVE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
YAKIMA |
Zip Code Of The Provider |
989023713 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
1456 |
Number Of Medicare Beneficiaries |
774 |
Total Submitted Charge Amount |
479401 |
Total Medicare Allowed Amount |
161538.52 |
Total Medicare Payment Amount |
123761.06 |
Total Medicare Standardized Payment Amount |
128274.1 |
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 |
62 |
Number Of Medical Services |
1456 |
Number Of Medicare Beneficiaries With Medical Services |
774 |
Total Medical Submitted Charge Amount |
479401 |
Total Medical Medicare Allowed Amount |
161538.52 |
Total Medical Medicare Payment Amount |
123761.06 |
Total Medical Medicare Standardized Payment Amount |
128274.1 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
308 |
Number Of Beneficiaries Age 75 to 84 |
280 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
378 |
Number Of Male Beneficiaries |
396 |
Number Of Non Hispanic White Beneficiaries |
673 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
24 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
627 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4342 |