| National Provider Identifier [NPI]: | 1790870400 |
| Last Name Of The Provider | HOLMSTEAD |
| First Name Of The Provider | EARL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2006 BIRDIE THOMPSON DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | POCATELLO |
| Zip Code Of The Provider | 83201 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 855 |
| Number Of Medicare Beneficiaries | 236 |
| Total Submitted Charge Amount | 80087 |
| Total Medicare Allowed Amount | 44002.45 |
| Total Medicare Payment Amount | 31102.24 |
| Total Medicare Standardized Payment Amount | 34205.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 1980 |
| Total Drug Medicare AllowedAmount | 1746.85 |
| Total Drug Medicare PaymentAmount | 1702.93 |
| Total Drug Medicare Standardized Payment Amount | 1702.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 790 |
| Number Of Medicare Beneficiaries With Medical Services | 236 |
| Total Medical Submitted Charge Amount | 78107 |
| Total Medical Medicare Allowed Amount | 42255.6 |
| Total Medical Medicare Payment Amount | 29399.31 |
| Total Medical Medicare Standardized Payment Amount | 32502.42 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 20 |
| Percent Of With Hypertension | 35 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7482 |