National Provider Identifier [NPI]: |
1861715310 |
Last Name Of The Provider |
CROSBY |
First Name Of The Provider |
CHELSEA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1717 S J ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984054933 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
556 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
136805 |
Total Medicare Allowed Amount |
45479.93 |
Total Medicare Payment Amount |
35290.79 |
Total Medicare Standardized Payment Amount |
40955.08 |
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 |
17 |
Number Of Medical Services |
556 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
136805 |
Total Medical Medicare Allowed Amount |
45479.93 |
Total Medical Medicare Payment Amount |
35290.79 |
Total Medical Medicare Standardized Payment Amount |
40955.08 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
52 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
97 |
Number Of Non Hispanic White Beneficiaries |
170 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
136 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.2847 |