National Provider Identifier [NPI]: |
1043313067 |
Last Name Of The Provider |
MARSHALL |
First Name Of The Provider |
STEPHEN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1035 116TH AVENUE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BELLEVUE |
Zip Code Of The Provider |
98004 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
221 |
Number Of Medicare Beneficiaries |
172 |
Total Submitted Charge Amount |
104471.6 |
Total Medicare Allowed Amount |
27209.88 |
Total Medicare Payment Amount |
20001.29 |
Total Medicare Standardized Payment Amount |
19865.48 |
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 |
18 |
Number Of Medical Services |
221 |
Number Of Medicare Beneficiaries With Medical Services |
172 |
Total Medical Submitted Charge Amount |
104471.6 |
Total Medical Medicare Allowed Amount |
27209.88 |
Total Medical Medicare Payment Amount |
20001.29 |
Total Medical Medicare Standardized Payment Amount |
19865.48 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
53 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
76 |
Number Of Non Hispanic White Beneficiaries |
151 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.6016 |