National Provider Identifier [NPI]: |
1669409785 |
Last Name Of The Provider |
MARKS |
First Name Of The Provider |
MELINDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
300 E JEFFERSON ST |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
BOISE |
Zip Code Of The Provider |
837126246 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
2869 |
Number Of Medicare Beneficiaries |
1437 |
Total Submitted Charge Amount |
264405 |
Total Medicare Allowed Amount |
132737.33 |
Total Medicare Payment Amount |
97724.05 |
Total Medicare Standardized Payment Amount |
105071.85 |
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 |
66 |
Number Of Medical Services |
2869 |
Number Of Medicare Beneficiaries With Medical Services |
1437 |
Total Medical Submitted Charge Amount |
264405 |
Total Medical Medicare Allowed Amount |
132737.33 |
Total Medical Medicare Payment Amount |
97724.05 |
Total Medical Medicare Standardized Payment Amount |
105071.85 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
206 |
Number Of Beneficiaries Age 65 to 74 |
497 |
Number Of Beneficiaries Age 75 to 84 |
456 |
Number Of Beneficiaries Age Greater 84 |
278 |
Number Of Female Beneficiaries |
739 |
Number Of Male Beneficiaries |
698 |
Number Of Non Hispanic White Beneficiaries |
1357 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
1162 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
275 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5302 |