National Provider Identifier [NPI]: |
1811919897 |
Last Name Of The Provider |
JANCHAR |
First Name Of The Provider |
TIMOTHY |
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 |
19300 SW 65TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUALATIN |
Zip Code Of The Provider |
970627706 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
429 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
210655 |
Total Medicare Allowed Amount |
42327.53 |
Total Medicare Payment Amount |
32926.43 |
Total Medicare Standardized Payment Amount |
33225.38 |
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 |
26 |
Number Of Medical Services |
429 |
Number Of Medicare Beneficiaries With Medical Services |
246 |
Total Medical Submitted Charge Amount |
210655 |
Total Medical Medicare Allowed Amount |
42327.53 |
Total Medical Medicare Payment Amount |
32926.43 |
Total Medical Medicare Standardized Payment Amount |
33225.38 |
Average Age Of Beneficiaries |
60 |
Number Of Beneficiaries Age Less65 |
139 |
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
32 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
161 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
172 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.1801 |