National Provider Identifier [NPI]: |
1568571362 |
Last Name Of The Provider |
MARTINEZ |
First Name Of The Provider |
SHAY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
325 9TH AVE |
Street Address 2 Of The Provider |
BOX 359780 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981042420 |
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 |
23 |
Number Of Services |
763 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
160767.5 |
Total Medicare Allowed Amount |
77135.8 |
Total Medicare Payment Amount |
58798.06 |
Total Medicare Standardized Payment Amount |
58213.17 |
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 |
23 |
Number Of Medical Services |
763 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
160767.5 |
Total Medical Medicare Allowed Amount |
77135.8 |
Total Medical Medicare Payment Amount |
58798.06 |
Total Medical Medicare Standardized Payment Amount |
58213.17 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
82 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
17 |
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 |
187 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9828 |