| National Provider Identifier [NPI]: | 1275507105 |
| Last Name Of The Provider | ENGELBRECHT |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1417 116TH AVE NE |
| Street Address 2 Of The Provider | STE 212 |
| City Of The Provider | BELLEVUE |
| Zip Code Of The Provider | 980043821 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 139 |
| Number Of Services | 2597 |
| Number Of Medicare Beneficiaries | 1659 |
| Total Submitted Charge Amount | 226238 |
| Total Medicare Allowed Amount | 90588.03 |
| Total Medicare Payment Amount | 66822.2 |
| Total Medicare Standardized Payment Amount | 65096.87 |
| 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 | 139 |
| Number Of Medical Services | 2597 |
| Number Of Medicare Beneficiaries With Medical Services | 1659 |
| Total Medical Submitted Charge Amount | 226238 |
| Total Medical Medicare Allowed Amount | 90588.03 |
| Total Medical Medicare Payment Amount | 66822.2 |
| Total Medical Medicare Standardized Payment Amount | 65096.87 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 499 |
| Number Of Beneficiaries Age 75 to 84 | 586 |
| Number Of Beneficiaries Age Greater 84 | 465 |
| Number Of Female Beneficiaries | 1000 |
| Number Of Male Beneficiaries | 659 |
| Number Of Non Hispanic White Beneficiaries | 1486 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1381 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 278 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4102 |