National Provider Identifier [NPI]: |
1760679179 |
Last Name Of The Provider |
MCCLENDON |
First Name Of The Provider |
ANNETTE |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
112 COLUMBIA POINT DRIVE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
RICHLAND |
Zip Code Of The Provider |
99352 |
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 |
33 |
Number Of Services |
1445 |
Number Of Medicare Beneficiaries |
271 |
Total Submitted Charge Amount |
107939 |
Total Medicare Allowed Amount |
48024.5 |
Total Medicare Payment Amount |
36155.22 |
Total Medicare Standardized Payment Amount |
43738.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
1445 |
Number Of Medicare Beneficiaries With Medical Services |
271 |
Total Medical Submitted Charge Amount |
107939 |
Total Medical Medicare Allowed Amount |
48024.5 |
Total Medical Medicare Payment Amount |
36155.22 |
Total Medical Medicare Standardized Payment Amount |
43738.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
168 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
241 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
218 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
53 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0546 |