| National Provider Identifier [NPI]: | 1538101795 |
| Last Name Of The Provider | GRUBB |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 611 31ST AVE SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUYALLUP |
| Zip Code Of The Provider | 983733723 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 1006 |
| Number Of Medicare Beneficiaries | 105 |
| Total Submitted Charge Amount | 61070.63 |
| Total Medicare Allowed Amount | 35699.03 |
| Total Medicare Payment Amount | 27934.21 |
| Total Medicare Standardized Payment Amount | 28085.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 159 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 3332.98 |
| Total Drug Medicare AllowedAmount | 2452.84 |
| Total Drug Medicare PaymentAmount | 2062.58 |
| Total Drug Medicare Standardized Payment Amount | 2062.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 847 |
| Number Of Medicare Beneficiaries With Medical Services | 105 |
| Total Medical Submitted Charge Amount | 57737.65 |
| Total Medical Medicare Allowed Amount | 33246.19 |
| Total Medical Medicare Payment Amount | 25871.63 |
| Total Medical Medicare Standardized Payment Amount | 26022.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 15 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0267 |