| National Provider Identifier [NPI]: | 1730157199 |
| Last Name Of The Provider | TOMBERG |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 380 WINSLOW WAY E |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAINBRIDGE ISLAND |
| Zip Code Of The Provider | 981102424 |
| 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 | 81 |
| Number Of Services | 1952 |
| Number Of Medicare Beneficiaries | 416 |
| Total Submitted Charge Amount | 297614.24 |
| Total Medicare Allowed Amount | 98728.21 |
| Total Medicare Payment Amount | 71398.75 |
| Total Medicare Standardized Payment Amount | 72650.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 200 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 5620.57 |
| Total Drug Medicare AllowedAmount | 3460.57 |
| Total Drug Medicare PaymentAmount | 3330.92 |
| Total Drug Medicare Standardized Payment Amount | 3330.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 1752 |
| Number Of Medicare Beneficiaries With Medical Services | 416 |
| Total Medical Submitted Charge Amount | 291993.67 |
| Total Medical Medicare Allowed Amount | 95267.64 |
| Total Medical Medicare Payment Amount | 68067.83 |
| Total Medical Medicare Standardized Payment Amount | 69319.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 246 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 233 |
| Number Of Non Hispanic White Beneficiaries | 393 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 387 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8641 |