National Provider Identifier [NPI]: |
1700824505 |
Last Name Of The Provider |
HOBSON |
First Name Of The Provider |
JON |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
440 NW DIVISION ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRESHAM |
Zip Code Of The Provider |
970305506 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
763 |
Number Of Medicare Beneficiaries |
232 |
Total Submitted Charge Amount |
108880.54 |
Total Medicare Allowed Amount |
50210.9 |
Total Medicare Payment Amount |
33086.53 |
Total Medicare Standardized Payment Amount |
33152.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
88 |
Number Of Medicare Beneficiaries With Drug Services |
55 |
Total Drug Submitted ChargeAmount |
2997.29 |
Total Drug Medicare AllowedAmount |
2934.58 |
Total Drug Medicare PaymentAmount |
2858.43 |
Total Drug Medicare Standardized Payment Amount |
2858.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
675 |
Number Of Medicare Beneficiaries With Medical Services |
232 |
Total Medical Submitted Charge Amount |
105883.25 |
Total Medical Medicare Allowed Amount |
47276.32 |
Total Medical Medicare Payment Amount |
30228.1 |
Total Medical Medicare Standardized Payment Amount |
30293.65 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
55 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
207 |
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 |
178 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0639 |