| National Provider Identifier [NPI]: | 1487760740 |
| Last Name Of The Provider | LITTLE |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4750 N FIVE MILE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837132715 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 266 |
| Number Of Medicare Beneficiaries | 148 |
| Total Submitted Charge Amount | 15146.5 |
| Total Medicare Allowed Amount | 13239.83 |
| Total Medicare Payment Amount | 9101.36 |
| Total Medicare Standardized Payment Amount | 10015.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 212 |
| Total Drug Medicare AllowedAmount | 161.89 |
| Total Drug Medicare PaymentAmount | 157.08 |
| Total Drug Medicare Standardized Payment Amount | 157.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 248 |
| Number Of Medicare Beneficiaries With Medical Services | 148 |
| Total Medical Submitted Charge Amount | 14934.5 |
| Total Medical Medicare Allowed Amount | 13077.94 |
| Total Medical Medicare Payment Amount | 8944.28 |
| Total Medical Medicare Standardized Payment Amount | 9857.95 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9784 |