National Provider Identifier [NPI]: |
1164581781 |
Last Name Of The Provider |
HERRING |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
410 B BLACK HILLS LN SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
OLYMPIA |
Zip Code Of The Provider |
985028667 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
3346 |
Number Of Medicare Beneficiaries |
596 |
Total Submitted Charge Amount |
310019 |
Total Medicare Allowed Amount |
216172.03 |
Total Medicare Payment Amount |
155232.01 |
Total Medicare Standardized Payment Amount |
156735.55 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
321 |
Number Of Medicare Beneficiaries With Drug Services |
291 |
Total Drug Submitted ChargeAmount |
8730 |
Total Drug Medicare AllowedAmount |
8507.8 |
Total Drug Medicare PaymentAmount |
8289.15 |
Total Drug Medicare Standardized Payment Amount |
8289.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
3025 |
Number Of Medicare Beneficiaries With Medical Services |
595 |
Total Medical Submitted Charge Amount |
301289 |
Total Medical Medicare Allowed Amount |
207664.23 |
Total Medical Medicare Payment Amount |
146942.86 |
Total Medical Medicare Standardized Payment Amount |
148446.4 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
224 |
Number Of Beneficiaries Age Greater 84 |
149 |
Number Of Female Beneficiaries |
319 |
Number Of Male Beneficiaries |
277 |
Number Of Non Hispanic White Beneficiaries |
560 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
14 |
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 |
568 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.044 |