National Provider Identifier [NPI]: |
1447342027 |
Last Name Of The Provider |
HOOD |
First Name Of The Provider |
CONSTANCE |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
PAC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
24080 SE KENT KANGLEY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MAPLE VALLEY |
Zip Code Of The Provider |
980386801 |
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 |
34 |
Number Of Services |
491 |
Number Of Medicare Beneficiaries |
118 |
Total Submitted Charge Amount |
62951 |
Total Medicare Allowed Amount |
28237.34 |
Total Medicare Payment Amount |
18846.84 |
Total Medicare Standardized Payment Amount |
20939.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
108 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
3312 |
Total Drug Medicare AllowedAmount |
2299.68 |
Total Drug Medicare PaymentAmount |
2082.53 |
Total Drug Medicare Standardized Payment Amount |
2082.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
383 |
Number Of Medicare Beneficiaries With Medical Services |
118 |
Total Medical Submitted Charge Amount |
59639 |
Total Medical Medicare Allowed Amount |
25937.66 |
Total Medical Medicare Payment Amount |
16764.31 |
Total Medical Medicare Standardized Payment Amount |
18856.63 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
35 |
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 |
19 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.031 |