| National Provider Identifier [NPI]: | 1902893498 |
| Last Name Of The Provider | SACKSEN |
| First Name Of The Provider | INGEBORG |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 470 BIRCHWOOD AVE |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | BELLINGHAM |
| Zip Code Of The Provider | 982251781 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1313 |
| Number Of Medicare Beneficiaries | 117 |
| Total Submitted Charge Amount | 81696.45 |
| Total Medicare Allowed Amount | 41563.95 |
| Total Medicare Payment Amount | 31532.72 |
| Total Medicare Standardized Payment Amount | 31358.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1053 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 20580 |
| Total Drug Medicare AllowedAmount | 15644.71 |
| Total Drug Medicare PaymentAmount | 12272.51 |
| Total Drug Medicare Standardized Payment Amount | 12272.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 260 |
| Number Of Medicare Beneficiaries With Medical Services | 117 |
| Total Medical Submitted Charge Amount | 61116.45 |
| Total Medical Medicare Allowed Amount | 25919.24 |
| Total Medical Medicare Payment Amount | 19260.21 |
| Total Medical Medicare Standardized Payment Amount | 19086.44 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 81 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 88 |
| 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 | 70 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3217 |