National Provider Identifier [NPI]: |
1629147103 |
Last Name Of The Provider |
YOUNG |
First Name Of The Provider |
GAVIN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1607 LINCOLN WAY |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
COEUR D ALENE |
Zip Code Of The Provider |
838142462 |
State Code Of The Provider |
ID |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
1114 |
Number Of Medicare Beneficiaries |
610 |
Total Submitted Charge Amount |
452575 |
Total Medicare Allowed Amount |
157320.75 |
Total Medicare Payment Amount |
122279.68 |
Total Medicare Standardized Payment Amount |
132378.73 |
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 |
53 |
Number Of Medical Services |
1114 |
Number Of Medicare Beneficiaries With Medical Services |
610 |
Total Medical Submitted Charge Amount |
452575 |
Total Medical Medicare Allowed Amount |
157320.75 |
Total Medical Medicare Payment Amount |
122279.68 |
Total Medical Medicare Standardized Payment Amount |
132378.73 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
282 |
Number Of Beneficiaries Age 75 to 84 |
179 |
Number Of Beneficiaries Age Greater 84 |
50 |
Number Of Female Beneficiaries |
323 |
Number Of Male Beneficiaries |
287 |
Number Of Non Hispanic White Beneficiaries |
579 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
481 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.283 |