National Provider Identifier [NPI]: |
1932149176 |
Last Name Of The Provider |
CARLSON |
First Name Of The Provider |
MOLLY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
904 7TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981041132 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
1983 |
Number Of Medicare Beneficiaries |
305 |
Total Submitted Charge Amount |
181234.24 |
Total Medicare Allowed Amount |
67165.79 |
Total Medicare Payment Amount |
51932.55 |
Total Medicare Standardized Payment Amount |
50612.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
212 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
6967.24 |
Total Drug Medicare AllowedAmount |
3918.81 |
Total Drug Medicare PaymentAmount |
3063.24 |
Total Drug Medicare Standardized Payment Amount |
3063.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
1771 |
Number Of Medicare Beneficiaries With Medical Services |
305 |
Total Medical Submitted Charge Amount |
174267 |
Total Medical Medicare Allowed Amount |
63246.98 |
Total Medical Medicare Payment Amount |
48869.31 |
Total Medical Medicare Standardized Payment Amount |
47549.27 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
183 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
266 |
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 |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
282 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2103 |