National Provider Identifier [NPI]: |
1881770774 |
Last Name Of The Provider |
BUNDESMANN |
First Name Of The Provider |
MICHAEL |
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 |
1959 NE PACIFIC ST. |
Street Address 2 Of The Provider |
MEDICAL SPECIALTIES BOX 356166 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981094714 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
835 |
Number Of Medicare Beneficiaries |
242 |
Total Submitted Charge Amount |
134938 |
Total Medicare Allowed Amount |
62776.4 |
Total Medicare Payment Amount |
46005.27 |
Total Medicare Standardized Payment Amount |
46403.6 |
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 |
34 |
Number Of Medical Services |
835 |
Number Of Medicare Beneficiaries With Medical Services |
242 |
Total Medical Submitted Charge Amount |
134938 |
Total Medical Medicare Allowed Amount |
62776.4 |
Total Medical Medicare Payment Amount |
46005.27 |
Total Medical Medicare Standardized Payment Amount |
46403.6 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
91 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
216 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
194 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.2158 |