| National Provider Identifier [NPI]: | 1881646081 |
| Last Name Of The Provider | HEGGEM-SNOW |
| First Name Of The Provider | ALINE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 212 E CENTRAL AVE |
| Street Address 2 Of The Provider | STE 440 |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992086291 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 384 |
| Number Of Medicare Beneficiaries | 178 |
| Total Submitted Charge Amount | 99722 |
| Total Medicare Allowed Amount | 36654.7 |
| Total Medicare Payment Amount | 23570.06 |
| Total Medicare Standardized Payment Amount | 29241.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 9232 |
| Total Drug Medicare AllowedAmount | 3541.97 |
| Total Drug Medicare PaymentAmount | 2718.46 |
| Total Drug Medicare Standardized Payment Amount | 2718.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 355 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 90490 |
| Total Medical Medicare Allowed Amount | 33112.73 |
| Total Medical Medicare Payment Amount | 20851.6 |
| Total Medical Medicare Standardized Payment Amount | 26523.37 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 129 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 166 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 104 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 21 |
| Percent Of With Hypertension | 24 |
| Percent Of With Ischemic Heart Disease | 6 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 17 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2197 |