| National Provider Identifier [NPI]: | 1588630792 |
| Last Name Of The Provider | EBERLE |
| First Name Of The Provider | CORLENE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | ARNP FNPC ANPC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 733 5TH ST |
| Street Address 2 Of The Provider | STE M, LOW COST FAMILY HEALTH |
| City Of The Provider | CLARKSTON |
| Zip Code Of The Provider | 99403 |
| 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 | 134 |
| Number Of Services | 1987 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 105747.67 |
| Total Medicare Allowed Amount | 39738.78 |
| Total Medicare Payment Amount | 33254.27 |
| Total Medicare Standardized Payment Amount | 37873.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1467.67 |
| Total Drug Medicare AllowedAmount | 325.29 |
| Total Drug Medicare PaymentAmount | 309.31 |
| Total Drug Medicare Standardized Payment Amount | 309.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 1930 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 104280 |
| Total Medical Medicare Allowed Amount | 39413.49 |
| Total Medical Medicare Payment Amount | 32944.96 |
| Total Medical Medicare Standardized Payment Amount | 37564.04 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 0 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 112 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 79 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3559 |