National Provider Identifier [NPI]: |
1689813008 |
Last Name Of The Provider |
HOGBERG |
First Name Of The Provider |
TRAPPER |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 S MCCLELLAN ST |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992042457 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
390 |
Number Of Medicare Beneficiaries |
181 |
Total Submitted Charge Amount |
114187.38 |
Total Medicare Allowed Amount |
32063.28 |
Total Medicare Payment Amount |
24922.59 |
Total Medicare Standardized Payment Amount |
26399.01 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
44 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
109 |
Number Of Male Beneficiaries |
72 |
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 |
|
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
119 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8311 |