National Provider Identifier [NPI]: |
1043538440 |
Last Name Of The Provider |
GRABER |
First Name Of The Provider |
SEJAL |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1330 ROCKEFELLER AVE STE 200 |
Street Address 2 Of The Provider |
|
City Of The Provider |
EVERETT |
Zip Code Of The Provider |
982011677 |
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 |
78 |
Number Of Services |
533 |
Number Of Medicare Beneficiaries |
58 |
Total Submitted Charge Amount |
36649.5 |
Total Medicare Allowed Amount |
13741.58 |
Total Medicare Payment Amount |
9937.15 |
Total Medicare Standardized Payment Amount |
12625.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
151 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
1575.75 |
Total Drug Medicare AllowedAmount |
787.57 |
Total Drug Medicare PaymentAmount |
611.73 |
Total Drug Medicare Standardized Payment Amount |
611.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
382 |
Number Of Medicare Beneficiaries With Medical Services |
58 |
Total Medical Submitted Charge Amount |
35073.75 |
Total Medical Medicare Allowed Amount |
12954.01 |
Total Medical Medicare Payment Amount |
9325.42 |
Total Medical Medicare Standardized Payment Amount |
12013.94 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
19 |
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 |
|
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 |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
28 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0039 |