| National Provider Identifier [NPI]: | 1285795823 |
| Last Name Of The Provider | HART |
| First Name Of The Provider | SABRINA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10217 125TH STREET CT E |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | PUYALLUP |
| Zip Code Of The Provider | 983742761 |
| 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 | 25 |
| Number Of Services | 272 |
| Number Of Medicare Beneficiaries | 86 |
| Total Submitted Charge Amount | 54803 |
| Total Medicare Allowed Amount | 22493.57 |
| Total Medicare Payment Amount | 15480.71 |
| Total Medicare Standardized Payment Amount | 14686.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1605 |
| Total Drug Medicare AllowedAmount | 1031.83 |
| Total Drug Medicare PaymentAmount | 1011.18 |
| Total Drug Medicare Standardized Payment Amount | 1011.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 245 |
| Number Of Medicare Beneficiaries With Medical Services | 86 |
| Total Medical Submitted Charge Amount | 53198 |
| Total Medical Medicare Allowed Amount | 21461.74 |
| Total Medical Medicare Payment Amount | 14469.53 |
| Total Medical Medicare Standardized Payment Amount | 13675.6 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 31 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 58 |
| Number Of Male Beneficiaries | 28 |
| Number Of Non Hispanic White Beneficiaries | 46 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 46 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 37 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0583 |