National Provider Identifier [NPI]: |
1356493506 |
Last Name Of The Provider |
TOMICH |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2700 152ND AVE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
REDMOND |
Zip Code Of The Provider |
980525543 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
1407 |
Number Of Medicare Beneficiaries |
102 |
Total Submitted Charge Amount |
36707.6 |
Total Medicare Allowed Amount |
11453.87 |
Total Medicare Payment Amount |
7571.14 |
Total Medicare Standardized Payment Amount |
7969.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
1204 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
782.6 |
Total Drug Medicare AllowedAmount |
208.86 |
Total Drug Medicare PaymentAmount |
158.79 |
Total Drug Medicare Standardized Payment Amount |
158.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
203 |
Number Of Medicare Beneficiaries With Medical Services |
102 |
Total Medical Submitted Charge Amount |
35925 |
Total Medical Medicare Allowed Amount |
11245.01 |
Total Medical Medicare Payment Amount |
7412.35 |
Total Medical Medicare Standardized Payment Amount |
7810.55 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
45 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
84 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
24 |
Percent Of With Hypertension |
44 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4216 |