National Provider Identifier [NPI]: |
1508092784 |
Last Name Of The Provider |
MYREN |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
875 WESLEY ST |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
982231613 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
58 |
Number Of Services |
551 |
Number Of Medicare Beneficiaries |
138 |
Total Submitted Charge Amount |
103032 |
Total Medicare Allowed Amount |
45974.66 |
Total Medicare Payment Amount |
32913.09 |
Total Medicare Standardized Payment Amount |
33432.28 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
559 |
Total Drug Medicare AllowedAmount |
481.56 |
Total Drug Medicare PaymentAmount |
394.83 |
Total Drug Medicare Standardized Payment Amount |
394.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
529 |
Number Of Medicare Beneficiaries With Medical Services |
138 |
Total Medical Submitted Charge Amount |
102473 |
Total Medical Medicare Allowed Amount |
45493.1 |
Total Medical Medicare Payment Amount |
32518.26 |
Total Medical Medicare Standardized Payment Amount |
33037.45 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
89 |
Number Of Male Beneficiaries |
49 |
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 |
100 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
38 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4179 |