National Provider Identifier [NPI]: |
1053392597 |
Last Name Of The Provider |
GRETCH |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2620 WHEATON WAY |
Street Address 2 Of The Provider |
STE 1 |
City Of The Provider |
BREMERTON |
Zip Code Of The Provider |
983103335 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
11066 |
Number Of Medicare Beneficiaries |
1657 |
Total Submitted Charge Amount |
393739 |
Total Medicare Allowed Amount |
349979.54 |
Total Medicare Payment Amount |
252950.31 |
Total Medicare Standardized Payment Amount |
255772.03 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
626 |
Number Of Medicare Beneficiaries With Drug Services |
89 |
Total Drug Submitted ChargeAmount |
5650 |
Total Drug Medicare AllowedAmount |
5519.23 |
Total Drug Medicare PaymentAmount |
4513.89 |
Total Drug Medicare Standardized Payment Amount |
4513.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
10440 |
Number Of Medicare Beneficiaries With Medical Services |
1657 |
Total Medical Submitted Charge Amount |
388089 |
Total Medical Medicare Allowed Amount |
344460.31 |
Total Medical Medicare Payment Amount |
248436.42 |
Total Medical Medicare Standardized Payment Amount |
251258.14 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
642 |
Number Of Beneficiaries Age 75 to 84 |
523 |
Number Of Beneficiaries Age Greater 84 |
354 |
Number Of Female Beneficiaries |
907 |
Number Of Male Beneficiaries |
750 |
Number Of Non Hispanic White Beneficiaries |
1549 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
12 |
Number Of Beneficiaries With Race Not Else where Classified |
28 |
Number Of Beneficiaries With Medicare Only Entitlement |
1465 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
192 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3425 |