National Provider Identifier [NPI]: |
1518915149 |
Last Name Of The Provider |
DEMLOW |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 NE MOTHER JOSEPH PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
VANCOUVER |
Zip Code Of The Provider |
986643200 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
160 |
Number Of Services |
3190 |
Number Of Medicare Beneficiaries |
2003 |
Total Submitted Charge Amount |
354791.21 |
Total Medicare Allowed Amount |
112369.31 |
Total Medicare Payment Amount |
85741.33 |
Total Medicare Standardized Payment Amount |
88464.4 |
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 |
160 |
Number Of Medical Services |
3190 |
Number Of Medicare Beneficiaries With Medical Services |
2003 |
Total Medical Submitted Charge Amount |
354791.21 |
Total Medical Medicare Allowed Amount |
112369.31 |
Total Medical Medicare Payment Amount |
85741.33 |
Total Medical Medicare Standardized Payment Amount |
88464.4 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
443 |
Number Of Beneficiaries Age 65 to 74 |
672 |
Number Of Beneficiaries Age 75 to 84 |
534 |
Number Of Beneficiaries Age Greater 84 |
354 |
Number Of Female Beneficiaries |
1112 |
Number Of Male Beneficiaries |
891 |
Number Of Non Hispanic White Beneficiaries |
1769 |
Number Of Black or African American Beneficiaries |
39 |
Number Of AsianPacific Islander Beneficiaries |
59 |
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
20 |
Number Of Beneficiaries With Race Not Else where Classified |
53 |
Number Of Beneficiaries With Medicare Only Entitlement |
1197 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
806 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8871 |