National Provider Identifier [NPI]: |
1043209315 |
Last Name Of The Provider |
TOBIAS |
First Name Of The Provider |
SHARON |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3200 PROVIDENCE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ANCHORAGE |
Zip Code Of The Provider |
995084661 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1259 |
Number Of Medicare Beneficiaries |
428 |
Total Submitted Charge Amount |
380615 |
Total Medicare Allowed Amount |
64444.59 |
Total Medicare Payment Amount |
49700.77 |
Total Medicare Standardized Payment Amount |
32688.86 |
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 |
20 |
Number Of Medical Services |
1259 |
Number Of Medicare Beneficiaries With Medical Services |
428 |
Total Medical Submitted Charge Amount |
380615 |
Total Medical Medicare Allowed Amount |
64444.59 |
Total Medical Medicare Payment Amount |
49700.77 |
Total Medical Medicare Standardized Payment Amount |
32688.86 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
199 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
257 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
351 |
Number Of Black or African American Beneficiaries |
14 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
16 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
310 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
25 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.548 |