| National Provider Identifier [NPI]: | 1811246531 |
| Last Name Of The Provider | VELICKOFF |
| First Name Of The Provider | SHELLEY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | A.R.N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1901 S UNION AVE |
| Street Address 2 Of The Provider | STE B3003 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984051702 |
| 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 | 44 |
| Number Of Services | 1625 |
| Number Of Medicare Beneficiaries | 396 |
| Total Submitted Charge Amount | 144712.18 |
| Total Medicare Allowed Amount | 77570.65 |
| Total Medicare Payment Amount | 57011.67 |
| Total Medicare Standardized Payment Amount | 67362.61 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 152 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 347 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| 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 | 343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1169 |