| National Provider Identifier [NPI]: | 1104936053 |
| Last Name Of The Provider | SHAW |
| First Name Of The Provider | ALLISON |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1959 NE PACIFIC ST |
| Street Address 2 Of The Provider | C212, BOX 356340 |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981956340 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 2618 |
| Number Of Medicare Beneficiaries | 868 |
| Total Submitted Charge Amount | 302681 |
| Total Medicare Allowed Amount | 96226.98 |
| Total Medicare Payment Amount | 75302.03 |
| Total Medicare Standardized Payment Amount | 53248.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 2618 |
| Number Of Medicare Beneficiaries With Medical Services | 868 |
| Total Medical Submitted Charge Amount | 302681 |
| Total Medical Medicare Allowed Amount | 96226.98 |
| Total Medical Medicare Payment Amount | 75302.03 |
| Total Medical Medicare Standardized Payment Amount | 53248.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 422 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 500 |
| Number Of Male Beneficiaries | 368 |
| Number Of Non Hispanic White Beneficiaries | 445 |
| Number Of Black or African American Beneficiaries | 173 |
| Number Of AsianPacific Islander Beneficiaries | 166 |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 593 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 275 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3421 |