| National Provider Identifier [NPI]: | 1891924551 |
| Last Name Of The Provider | CHAMBERLAIN |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MSN, ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 916 PACIFIC AVE |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | EVERETT |
| Zip Code Of The Provider | 982014147 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 282 |
| Number Of Medicare Beneficiaries | 127 |
| Total Submitted Charge Amount | 49073 |
| Total Medicare Allowed Amount | 19871.79 |
| Total Medicare Payment Amount | 15396.8 |
| Total Medicare Standardized Payment Amount | 18229.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 638 |
| Total Drug Medicare AllowedAmount | 506.9 |
| Total Drug Medicare PaymentAmount | 496.22 |
| Total Drug Medicare Standardized Payment Amount | 496.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 255 |
| Number Of Medicare Beneficiaries With Medical Services | 127 |
| Total Medical Submitted Charge Amount | 48435 |
| Total Medical Medicare Allowed Amount | 19364.89 |
| Total Medical Medicare Payment Amount | 14900.58 |
| Total Medical Medicare Standardized Payment Amount | 17733.72 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 108 |
| 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 | 69 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0551 |