| National Provider Identifier [NPI]: | 1942259288 |
| Last Name Of The Provider | SUBOCZ |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 NE MOTHER JOSEPH PL |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | VANCOUVER |
| Zip Code Of The Provider | 986643299 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1625 |
| Number Of Medicare Beneficiaries | 981 |
| Total Submitted Charge Amount | 404310 |
| Total Medicare Allowed Amount | 122647.4 |
| Total Medicare Payment Amount | 90745.2 |
| Total Medicare Standardized Payment Amount | 92729.28 |
| 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 | 45 |
| Number Of Medical Services | 1625 |
| Number Of Medicare Beneficiaries With Medical Services | 981 |
| Total Medical Submitted Charge Amount | 404310 |
| Total Medical Medicare Allowed Amount | 122647.4 |
| Total Medical Medicare Payment Amount | 90745.2 |
| Total Medical Medicare Standardized Payment Amount | 92729.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 163 |
| Number Of Beneficiaries Age 65 to 74 | 322 |
| Number Of Beneficiaries Age 75 to 84 | 318 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 512 |
| Number Of Male Beneficiaries | 469 |
| Number Of Non Hispanic White Beneficiaries | 901 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 683 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 298 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8141 |