| National Provider Identifier [NPI]: | 1093073926 |
| Last Name Of The Provider | RICHLIE |
| First Name Of The Provider | TARYN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5980 PINEWOOD LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | MISSOULA |
| Zip Code Of The Provider | 598033030 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 308 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 28235 |
| Total Medicare Allowed Amount | 15709.74 |
| Total Medicare Payment Amount | 8410.93 |
| Total Medicare Standardized Payment Amount | 11809.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 228 |
| Total Drug Medicare AllowedAmount | 78.66 |
| Total Drug Medicare PaymentAmount | 38.54 |
| Total Drug Medicare Standardized Payment Amount | 38.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 268 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 28007 |
| Total Medical Medicare Allowed Amount | 15631.08 |
| Total Medical Medicare Payment Amount | 8372.39 |
| Total Medical Medicare Standardized Payment Amount | 11770.98 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 39 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 41 |
| 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 | 74 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0654 |