| National Provider Identifier [NPI]: | 1154385292 |
| Last Name Of The Provider | ANDERSEN |
| First Name Of The Provider | CLARE |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 15TH AVE SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUYALLUP |
| Zip Code Of The Provider | 983723754 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 8231 |
| Number Of Medicare Beneficiaries | 3374 |
| Total Submitted Charge Amount | 724568 |
| Total Medicare Allowed Amount | 228956.19 |
| Total Medicare Payment Amount | 186529.4 |
| Total Medicare Standardized Payment Amount | 186857.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3178 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 6386 |
| Total Drug Medicare AllowedAmount | 662.8 |
| Total Drug Medicare PaymentAmount | 519.63 |
| Total Drug Medicare Standardized Payment Amount | 519.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 5053 |
| Number Of Medicare Beneficiaries With Medical Services | 3374 |
| Total Medical Submitted Charge Amount | 718182 |
| Total Medical Medicare Allowed Amount | 228293.39 |
| Total Medical Medicare Payment Amount | 186009.77 |
| Total Medical Medicare Standardized Payment Amount | 186337.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 487 |
| Number Of Beneficiaries Age 65 to 74 | 1367 |
| Number Of Beneficiaries Age 75 to 84 | 978 |
| Number Of Beneficiaries Age Greater 84 | 542 |
| Number Of Female Beneficiaries | 2393 |
| Number Of Male Beneficiaries | 981 |
| Number Of Non Hispanic White Beneficiaries | 2963 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | 100 |
| Number Of Hispanic Beneficiaries | 90 |
| Number Of American Indian Alaska Native Beneficiaries | 32 |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 608 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3156 |