National Provider Identifier [NPI]: |
1518956853 |
Last Name Of The Provider |
PIATT |
First Name Of The Provider |
MARTIN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4545 CORDATA PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLINGHAM |
Zip Code Of The Provider |
982267123 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
635 |
Number Of Medicare Beneficiaries |
167 |
Total Submitted Charge Amount |
102112.97 |
Total Medicare Allowed Amount |
35739.26 |
Total Medicare Payment Amount |
24353.63 |
Total Medicare Standardized Payment Amount |
24711.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
191 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1041.85 |
Total Drug Medicare AllowedAmount |
521.31 |
Total Drug Medicare PaymentAmount |
487.06 |
Total Drug Medicare Standardized Payment Amount |
487.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
444 |
Number Of Medicare Beneficiaries With Medical Services |
167 |
Total Medical Submitted Charge Amount |
101071.12 |
Total Medical Medicare Allowed Amount |
35217.95 |
Total Medical Medicare Payment Amount |
23866.57 |
Total Medical Medicare Standardized Payment Amount |
24224.01 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
93 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
142 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
132 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
35 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8667 |