| National Provider Identifier [NPI]: | 1053307926 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | SHAWNA |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3700 PACIFIC HWY E |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | FIFE |
| Zip Code Of The Provider | 984241148 |
| 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 | 83 |
| Number Of Services | 63764 |
| Number Of Medicare Beneficiaries | 88 |
| Total Submitted Charge Amount | 2692749.1 |
| Total Medicare Allowed Amount | 881705.46 |
| Total Medicare Payment Amount | 689797.66 |
| Total Medicare Standardized Payment Amount | 682150.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 58 |
| Number Of Drug Services | 46680 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 2396508.24 |
| Total Drug Medicare AllowedAmount | 787642.05 |
| Total Drug Medicare PaymentAmount | 616725.59 |
| Total Drug Medicare Standardized Payment Amount | 616725.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 17084 |
| Number Of Medicare Beneficiaries With Medical Services | 88 |
| Total Medical Submitted Charge Amount | 296240.86 |
| Total Medical Medicare Allowed Amount | 94063.41 |
| Total Medical Medicare Payment Amount | 73072.07 |
| Total Medical Medicare Standardized Payment Amount | 65424.97 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | 68 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 59 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 2.1443 |