National Provider Identifier [NPI]: |
1013966860 |
Last Name Of The Provider |
SCHILLIOS |
First Name Of The Provider |
TERRY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 S MCCLELLAN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPOKANE |
Zip Code Of The Provider |
992042457 |
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 |
931 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
100584 |
Total Medicare Allowed Amount |
38048.82 |
Total Medicare Payment Amount |
27457.61 |
Total Medicare Standardized Payment Amount |
32663.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
591 |
Total Drug Medicare AllowedAmount |
412.82 |
Total Drug Medicare PaymentAmount |
326.99 |
Total Drug Medicare Standardized Payment Amount |
326.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
78 |
Number Of Medical Services |
905 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
99993 |
Total Medical Medicare Allowed Amount |
37636 |
Total Medical Medicare Payment Amount |
27130.62 |
Total Medical Medicare Standardized Payment Amount |
32336.24 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
102 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
54 |
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 |
208 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0475 |