| National Provider Identifier [NPI]: | 1235299181 |
| Last Name Of The Provider | ROSS |
| First Name Of The Provider | HARRY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 225 176TH ST S |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPANAWAY |
| Zip Code Of The Provider | 983879201 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 492 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 89831 |
| Total Medicare Allowed Amount | 32364.19 |
| Total Medicare Payment Amount | 20598.36 |
| Total Medicare Standardized Payment Amount | 25403.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 975 |
| Total Drug Medicare AllowedAmount | 741.43 |
| Total Drug Medicare PaymentAmount | 724.04 |
| Total Drug Medicare Standardized Payment Amount | 724.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 463 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 88856 |
| Total Medical Medicare Allowed Amount | 31622.76 |
| Total Medical Medicare Payment Amount | 19874.32 |
| Total Medical Medicare Standardized Payment Amount | 24679.02 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 83 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 131 |
| 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 | 99 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4247 |