National Provider Identifier [NPI]: |
1922162023 |
Last Name Of The Provider |
ROSELLE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1035 116TH AVE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLEVUE |
Zip Code Of The Provider |
980044604 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
541 |
Number Of Medicare Beneficiaries |
420 |
Total Submitted Charge Amount |
253540.2 |
Total Medicare Allowed Amount |
65882.04 |
Total Medicare Payment Amount |
49413.08 |
Total Medicare Standardized Payment Amount |
48380.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
541 |
Number Of Medicare Beneficiaries With Medical Services |
420 |
Total Medical Submitted Charge Amount |
253540.2 |
Total Medical Medicare Allowed Amount |
65882.04 |
Total Medical Medicare Payment Amount |
49413.08 |
Total Medical Medicare Standardized Payment Amount |
48380.01 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
145 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
362 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
26 |
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 |
316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
104 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6581 |