National Provider Identifier [NPI]: |
1780605972 |
Last Name Of The Provider |
EARHART |
First Name Of The Provider |
TRICIA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14408 E SPRAGUE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE VALLEY |
Zip Code Of The Provider |
992162167 |
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 |
116 |
Number Of Services |
1582 |
Number Of Medicare Beneficiaries |
292 |
Total Submitted Charge Amount |
134446.9 |
Total Medicare Allowed Amount |
47254.1 |
Total Medicare Payment Amount |
34949.99 |
Total Medicare Standardized Payment Amount |
39696.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
137 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
717.26 |
Total Drug Medicare AllowedAmount |
323.67 |
Total Drug Medicare PaymentAmount |
304.84 |
Total Drug Medicare Standardized Payment Amount |
304.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
110 |
Number Of Medical Services |
1445 |
Number Of Medicare Beneficiaries With Medical Services |
292 |
Total Medical Submitted Charge Amount |
133729.64 |
Total Medical Medicare Allowed Amount |
46930.43 |
Total Medical Medicare Payment Amount |
34645.15 |
Total Medical Medicare Standardized Payment Amount |
39391.94 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
121 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
225 |
Number Of Male Beneficiaries |
67 |
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 |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1397 |