| National Provider Identifier [NPI]: | 1750425849 |
| Last Name Of The Provider | BLOOMQUIST |
| First Name Of The Provider | SHEILA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 E STATE HIGHWAY 260 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PAYSON |
| Zip Code Of The Provider | 855414921 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 1780 |
| Number Of Medicare Beneficiaries | 569 |
| Total Submitted Charge Amount | 217557.8 |
| Total Medicare Allowed Amount | 86668.57 |
| Total Medicare Payment Amount | 58282.72 |
| Total Medicare Standardized Payment Amount | 58887.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 746 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 7124 |
| Total Drug Medicare AllowedAmount | 706.36 |
| Total Drug Medicare PaymentAmount | 474.77 |
| Total Drug Medicare Standardized Payment Amount | 474.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 1034 |
| Number Of Medicare Beneficiaries With Medical Services | 568 |
| Total Medical Submitted Charge Amount | 210433.8 |
| Total Medical Medicare Allowed Amount | 85962.21 |
| Total Medical Medicare Payment Amount | 57807.95 |
| Total Medical Medicare Standardized Payment Amount | 58412.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 320 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 471 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 68 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.978 |