| National Provider Identifier [NPI]: | 1669457693 |
| Last Name Of The Provider | NORTH |
| First Name Of The Provider | KERRIE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | PA C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1095 MARSHALL WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLACERVILLE |
| Zip Code Of The Provider | 956678238 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 306 |
| Number Of Medicare Beneficiaries | 96 |
| Total Submitted Charge Amount | 27387.02 |
| Total Medicare Allowed Amount | 15453.18 |
| Total Medicare Payment Amount | 11024.87 |
| Total Medicare Standardized Payment Amount | 12484.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1213.02 |
| Total Drug Medicare AllowedAmount | 380.6 |
| Total Drug Medicare PaymentAmount | 356.53 |
| Total Drug Medicare Standardized Payment Amount | 356.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 252 |
| Number Of Medicare Beneficiaries With Medical Services | 96 |
| Total Medical Submitted Charge Amount | 26174 |
| Total Medical Medicare Allowed Amount | 15072.58 |
| Total Medical Medicare Payment Amount | 10668.34 |
| Total Medical Medicare Standardized Payment Amount | 12128.12 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 60 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 65 |
| 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 | 32 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8666 |