National Provider Identifier [NPI]: |
1972745230 |
Last Name Of The Provider |
MOBERG |
First Name Of The Provider |
PHILIP |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10330 MERIDIAN AVE N |
Street Address 2 Of The Provider |
SUITE 250 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981339451 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
8602 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
309828.55 |
Total Medicare Allowed Amount |
251859.7 |
Total Medicare Payment Amount |
182155.08 |
Total Medicare Standardized Payment Amount |
181319.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
7973 |
Number Of Medicare Beneficiaries With Drug Services |
53 |
Total Drug Submitted ChargeAmount |
195829.05 |
Total Drug Medicare AllowedAmount |
189547.9 |
Total Drug Medicare PaymentAmount |
138898.87 |
Total Drug Medicare Standardized Payment Amount |
138898.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
629 |
Number Of Medicare Beneficiaries With Medical Services |
181 |
Total Medical Submitted Charge Amount |
113999.5 |
Total Medical Medicare Allowed Amount |
62311.8 |
Total Medical Medicare Payment Amount |
43256.21 |
Total Medical Medicare Standardized Payment Amount |
42420.8 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
65 |
Number Of Non Hispanic White Beneficiaries |
166 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
18 |
Percent Of With Diabetes |
12 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
66 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0451 |