National Provider Identifier [NPI]: |
1598992737 |
Last Name Of The Provider |
HOCHWALT |
First Name Of The Provider |
PHILLIP |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 N CHELAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WENATCHEE |
Zip Code Of The Provider |
988012028 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
62 |
Number Of Services |
1530 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
480312.4 |
Total Medicare Allowed Amount |
185578.9 |
Total Medicare Payment Amount |
143206.13 |
Total Medicare Standardized Payment Amount |
143747.24 |
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 |
62 |
Number Of Medical Services |
1530 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
480312.4 |
Total Medical Medicare Allowed Amount |
185578.9 |
Total Medical Medicare Payment Amount |
143206.13 |
Total Medical Medicare Standardized Payment Amount |
143747.24 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
209 |
Number Of Beneficiaries Age 75 to 84 |
146 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
240 |
Number Of Male Beneficiaries |
245 |
Number Of Non Hispanic White Beneficiaries |
456 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
432 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.0522 |