National Provider Identifier [NPI]: |
1548259229 |
Last Name Of The Provider |
GOES |
First Name Of The Provider |
NELSON |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1124 COLUMBIA ST STE 600 |
Street Address 2 Of The Provider |
SWEDISH ORGAN TRANSPLANT |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981042046 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
379 |
Number Of Medicare Beneficiaries |
109 |
Total Submitted Charge Amount |
85398 |
Total Medicare Allowed Amount |
36170.76 |
Total Medicare Payment Amount |
25607.8 |
Total Medicare Standardized Payment Amount |
26878.34 |
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 |
11 |
Number Of Medical Services |
379 |
Number Of Medicare Beneficiaries With Medical Services |
109 |
Total Medical Submitted Charge Amount |
85398 |
Total Medical Medicare Allowed Amount |
36170.76 |
Total Medical Medicare Payment Amount |
25607.8 |
Total Medical Medicare Standardized Payment Amount |
26878.34 |
Average Age Of Beneficiaries |
54 |
Number Of Beneficiaries Age Less65 |
82 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
53 |
Number Of Male Beneficiaries |
56 |
Number Of Non Hispanic White Beneficiaries |
68 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
19 |
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 |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
15 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
6.4716 |