| National Provider Identifier [NPI]: | 1043322217 |
| Last Name Of The Provider | HEROLD |
| First Name Of The Provider | HEIDI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 435 S EAGLE RD STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAGLE |
| Zip Code Of The Provider | 836166018 |
| 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 | 42 |
| Number Of Services | 3939 |
| Number Of Medicare Beneficiaries | 1037 |
| Total Submitted Charge Amount | 411700 |
| Total Medicare Allowed Amount | 311952.66 |
| Total Medicare Payment Amount | 220643.23 |
| Total Medicare Standardized Payment Amount | 220701.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 396 |
| Number Of Medicare Beneficiaries With Drug Services | 126 |
| Total Drug Submitted ChargeAmount | 8454 |
| Total Drug Medicare AllowedAmount | 2768.48 |
| Total Drug Medicare PaymentAmount | 2506.37 |
| Total Drug Medicare Standardized Payment Amount | 2506.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 3543 |
| Number Of Medicare Beneficiaries With Medical Services | 1037 |
| Total Medical Submitted Charge Amount | 403246 |
| Total Medical Medicare Allowed Amount | 309184.18 |
| Total Medical Medicare Payment Amount | 218136.86 |
| Total Medical Medicare Standardized Payment Amount | 218195.07 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 529 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 164 |
| Number Of Female Beneficiaries | 824 |
| Number Of Male Beneficiaries | 213 |
| Number Of Non Hispanic White Beneficiaries | 987 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 997 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9703 |