National Provider Identifier [NPI]: |
1285946079 |
Last Name Of The Provider |
MATTHEWS |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 NE MOTHER JOSEPH PL |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
VANCOUVER |
Zip Code Of The Provider |
986643299 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
268 |
Number Of Medicare Beneficiaries |
124 |
Total Submitted Charge Amount |
95057 |
Total Medicare Allowed Amount |
24377.64 |
Total Medicare Payment Amount |
17918.91 |
Total Medicare Standardized Payment Amount |
19408.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
48 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
6993.76 |
Total Drug Medicare AllowedAmount |
5334.29 |
Total Drug Medicare PaymentAmount |
3975.77 |
Total Drug Medicare Standardized Payment Amount |
3975.77 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
220 |
Number Of Medicare Beneficiaries With Medical Services |
124 |
Total Medical Submitted Charge Amount |
88063.24 |
Total Medical Medicare Allowed Amount |
19043.35 |
Total Medical Medicare Payment Amount |
13943.14 |
Total Medical Medicare Standardized Payment Amount |
15432.7 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1433 |