| National Provider Identifier [NPI]: | 1699756783 |
| Last Name Of The Provider | TAYLOR |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3417 ENSIGN RD NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065075 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 8309 |
| Number Of Medicare Beneficiaries | 2652 |
| Total Submitted Charge Amount | 608535.01 |
| Total Medicare Allowed Amount | 203232.22 |
| Total Medicare Payment Amount | 166294.16 |
| Total Medicare Standardized Payment Amount | 169021.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4215 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2728.4 |
| Total Drug Medicare AllowedAmount | 1265.44 |
| Total Drug Medicare PaymentAmount | 992.11 |
| Total Drug Medicare Standardized Payment Amount | 992.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 190 |
| Number Of Medical Services | 4094 |
| Number Of Medicare Beneficiaries With Medical Services | 2652 |
| Total Medical Submitted Charge Amount | 605806.61 |
| Total Medical Medicare Allowed Amount | 201966.78 |
| Total Medical Medicare Payment Amount | 165302.05 |
| Total Medical Medicare Standardized Payment Amount | 168029.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 449 |
| Number Of Beneficiaries Age 65 to 74 | 1139 |
| Number Of Beneficiaries Age 75 to 84 | 727 |
| Number Of Beneficiaries Age Greater 84 | 337 |
| Number Of Female Beneficiaries | 1738 |
| Number Of Male Beneficiaries | 914 |
| Number Of Non Hispanic White Beneficiaries | 2445 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 48 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2099 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 553 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2589 |