National Provider Identifier [NPI]: |
1073519492 |
Last Name Of The Provider |
MCNAUGHTON |
First Name Of The Provider |
MARSE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3733 S THOMPSON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984185013 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
2847 |
Number Of Medicare Beneficiaries |
210 |
Total Submitted Charge Amount |
257338.57 |
Total Medicare Allowed Amount |
161494.81 |
Total Medicare Payment Amount |
112275.08 |
Total Medicare Standardized Payment Amount |
119036.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
350 |
Number Of Medicare Beneficiaries With Drug Services |
129 |
Total Drug Submitted ChargeAmount |
9739.54 |
Total Drug Medicare AllowedAmount |
6739.93 |
Total Drug Medicare PaymentAmount |
5564.87 |
Total Drug Medicare Standardized Payment Amount |
5564.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
2497 |
Number Of Medicare Beneficiaries With Medical Services |
210 |
Total Medical Submitted Charge Amount |
247599.03 |
Total Medical Medicare Allowed Amount |
154754.88 |
Total Medical Medicare Payment Amount |
106710.21 |
Total Medical Medicare Standardized Payment Amount |
113471.54 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
13 |
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 |
165 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2143 |