National Provider Identifier [NPI]: |
1649266321 |
Last Name Of The Provider |
GOLDBERG |
First Name Of The Provider |
SHELDON |
Middle Initial Of The Provider |
Z |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
515 MINOR AVE |
Street Address 2 Of The Provider |
SUITE 170 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981042120 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
116 |
Number Of Services |
21568 |
Number Of Medicare Beneficiaries |
334 |
Total Submitted Charge Amount |
891400.12 |
Total Medicare Allowed Amount |
289004.83 |
Total Medicare Payment Amount |
220957.79 |
Total Medicare Standardized Payment Amount |
215433.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
16072 |
Number Of Medicare Beneficiaries With Drug Services |
67 |
Total Drug Submitted ChargeAmount |
264478.12 |
Total Drug Medicare AllowedAmount |
76254.37 |
Total Drug Medicare PaymentAmount |
59097.42 |
Total Drug Medicare Standardized Payment Amount |
59097.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
103 |
Number Of Medical Services |
5496 |
Number Of Medicare Beneficiaries With Medical Services |
334 |
Total Medical Submitted Charge Amount |
626922 |
Total Medical Medicare Allowed Amount |
212750.46 |
Total Medical Medicare Payment Amount |
161860.37 |
Total Medical Medicare Standardized Payment Amount |
156336.3 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
182 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
243 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
32 |
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 |
287 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
28 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.0084 |