National Provider Identifier [NPI]: |
1992781678 |
Last Name Of The Provider |
HUDSPETH |
First Name Of The Provider |
TAMMI |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
315 MARTIN LUTHER KING JR WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984054234 |
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 |
7 |
Number Of Services |
359 |
Number Of Medicare Beneficiaries |
168 |
Total Submitted Charge Amount |
84969 |
Total Medicare Allowed Amount |
25910.05 |
Total Medicare Payment Amount |
19599.03 |
Total Medicare Standardized Payment Amount |
23618.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
359 |
Number Of Medicare Beneficiaries With Medical Services |
168 |
Total Medical Submitted Charge Amount |
84969 |
Total Medical Medicare Allowed Amount |
25910.05 |
Total Medical Medicare Payment Amount |
19599.03 |
Total Medical Medicare Standardized Payment Amount |
23618.98 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
74 |
Number Of Male Beneficiaries |
94 |
Number Of Non Hispanic White Beneficiaries |
128 |
Number Of Black or African American Beneficiaries |
19 |
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 |
122 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
44 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
74 |
Percent Of With Chronic Obstructive Pulmonary Disease |
47 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.5808 |