National Provider Identifier [NPI]: |
1437215472 |
Last Name Of The Provider |
TWE |
First Name Of The Provider |
SUI |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10056 SE 240TH ST STE D |
Street Address 2 Of The Provider |
|
City Of The Provider |
KENT |
Zip Code Of The Provider |
980315126 |
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 |
30 |
Number Of Services |
1409 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
152471 |
Total Medicare Allowed Amount |
87367.99 |
Total Medicare Payment Amount |
59227.18 |
Total Medicare Standardized Payment Amount |
56867.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
77 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
1715 |
Total Drug Medicare AllowedAmount |
737.71 |
Total Drug Medicare PaymentAmount |
697.59 |
Total Drug Medicare Standardized Payment Amount |
697.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
28 |
Number Of Medical Services |
1332 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
150756 |
Total Medical Medicare Allowed Amount |
86630.28 |
Total Medical Medicare Payment Amount |
58529.59 |
Total Medical Medicare Standardized Payment Amount |
56169.74 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
72 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
31 |
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 |
215 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
38 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9825 |