National Provider Identifier [NPI]: |
1083681480 |
Last Name Of The Provider |
KREHBIEL |
First Name Of The Provider |
ALICE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
509 OLIVE WAY |
Street Address 2 Of The Provider |
SUITE 900 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981011720 |
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 |
60 |
Number Of Services |
481 |
Number Of Medicare Beneficiaries |
57 |
Total Submitted Charge Amount |
46438.5 |
Total Medicare Allowed Amount |
19894.5 |
Total Medicare Payment Amount |
15382.12 |
Total Medicare Standardized Payment Amount |
14713.06 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
1170 |
Total Drug Medicare AllowedAmount |
895.07 |
Total Drug Medicare PaymentAmount |
877.13 |
Total Drug Medicare Standardized Payment Amount |
877.13 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
55 |
Number Of Medical Services |
461 |
Number Of Medicare Beneficiaries With Medical Services |
57 |
Total Medical Submitted Charge Amount |
45268.5 |
Total Medical Medicare Allowed Amount |
18999.43 |
Total Medical Medicare Payment Amount |
14504.99 |
Total Medical Medicare Standardized Payment Amount |
13835.93 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
45 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
0 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
21 |
Percent Of With Hypertension |
32 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7995 |