National Provider Identifier [NPI]: |
1447451794 |
Last Name Of The Provider |
ROGOSIN |
First Name Of The Provider |
SHANE |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9280 SE SUNNYBROOK BLVD |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
CLACKAMAS |
Zip Code Of The Provider |
970156776 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
18903 |
Number Of Medicare Beneficiaries |
184 |
Total Submitted Charge Amount |
777677 |
Total Medicare Allowed Amount |
422060.47 |
Total Medicare Payment Amount |
314309.49 |
Total Medicare Standardized Payment Amount |
312836.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
47 |
Number Of Drug Services |
17350 |
Number Of Medicare Beneficiaries With Drug Services |
48 |
Total Drug Submitted ChargeAmount |
500328 |
Total Drug Medicare AllowedAmount |
330918.87 |
Total Drug Medicare PaymentAmount |
245749.07 |
Total Drug Medicare Standardized Payment Amount |
245749.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
1553 |
Number Of Medicare Beneficiaries With Medical Services |
184 |
Total Medical Submitted Charge Amount |
277349 |
Total Medical Medicare Allowed Amount |
91141.6 |
Total Medical Medicare Payment Amount |
68560.42 |
Total Medical Medicare Standardized Payment Amount |
67087.2 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
71 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
110 |
Number Of Male Beneficiaries |
74 |
Number Of Non Hispanic White Beneficiaries |
167 |
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
45 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.7535 |