Medicare Facts for Michael T. Blackburn, MA


National Provider Identifier [NPI]: 1063429652
Last Name Of The Provider BLACKBURN
First Name Of The Provider MICHAEL
Middle Initial Of The Provider G
Credentials Of The Provider MD
Gender Of The Provider M
Entity Type Of The Provider I
Street Address 1 Of The Provider 201 15TH AVE SW STE C
Street Address 2 Of The Provider
City Of The Provider PUYALLUP
Zip Code Of The Provider 983717495
State Code Of The Provider WA
Country Code Of The Provider US
Provider Type Of The Provider Internal Medicine
Medicare Participation Indicator Y
Number Of HCPCS 28
Number Of Services 2450
Number Of Medicare Beneficiaries 472
Total Submitted Charge Amount 328249.71
Total Medicare Allowed Amount 182147.3
Total Medicare Payment Amount 122049.77
Total Medicare Standardized Payment Amount 122718.85
Drug Suppress Indicator
Number Of HCPCS Associated With Drug Services 8
Number Of Drug Services 325
Number Of Medicare Beneficiaries With Drug Services 90
Total Drug Submitted ChargeAmount 3006
Total Drug Medicare AllowedAmount 1195.61
Total Drug Medicare PaymentAmount 947.9
Total Drug Medicare Standardized Payment Amount 947.9
Medical SuppressIndicator
Number Of HCPCS Associated With MedicalServices 20
Number Of Medical Services 2125
Number Of Medicare Beneficiaries With Medical Services 472
Total Medical Submitted Charge Amount 325243.71
Total Medical Medicare Allowed Amount 180951.69
Total Medical Medicare Payment Amount 121101.87
Total Medical Medicare Standardized Payment Amount 121770.95
Average Age Of Beneficiaries 77
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74 187
Number Of Beneficiaries Age 75 to 84 190
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 253
Number Of Male Beneficiaries 219
Number Of Non Hispanic White Beneficiaries 453
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
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation 12
Percent Of With Alzheimers Disease or Dementia 8
Percent Of With Asthma 4
Percent Of With Cancer 12
Percent Of With Heart Failure 16
Percent Of With Chronic Kidney Disease 13
Percent Of With Chronic Obstructive Pulmonary Disease 5
Percent Of With Depression 7
Percent Of With Diabetes 24
Percent Of With Hyperlipidemia 33
Percent Of With Hypertension 50
Percent Of With Ischemic Heart Disease 20
Percent Of With Osteoporosis 4
Percent Of With Rheumatoid Arthritis Osteoarthritis 39
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke 4
Average HCC Risk Score Of Beneficiaries 0.945

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