National Provider Identifier [NPI]: |
1790976207 |
Last Name Of The Provider |
LING |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1793 13TH ST SE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALEM |
Zip Code Of The Provider |
973022541 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
6454 |
Number Of Medicare Beneficiaries |
567 |
Total Submitted Charge Amount |
679860 |
Total Medicare Allowed Amount |
231782.07 |
Total Medicare Payment Amount |
168219.81 |
Total Medicare Standardized Payment Amount |
197209.32 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
257 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
282 |
Number Of Non Hispanic White Beneficiaries |
537 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
513 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0706 |