National Provider Identifier [NPI]: |
1689976813 |
Last Name Of The Provider |
DEMALINE |
First Name Of The Provider |
ASHLEY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11820 NORTHUP WAY |
Street Address 2 Of The Provider |
SUITE E226 |
City Of The Provider |
BELLEVUE |
Zip Code Of The Provider |
980051946 |
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 |
19 |
Number Of Services |
195 |
Number Of Medicare Beneficiaries |
77 |
Total Submitted Charge Amount |
55250.52 |
Total Medicare Allowed Amount |
21584.03 |
Total Medicare Payment Amount |
16329.47 |
Total Medicare Standardized Payment Amount |
18986.83 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
30 |
Number Of Non Hispanic White Beneficiaries |
65 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
38 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
58 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
18 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.0875 |