| National Provider Identifier [NPI]: | 1679562136 |
| Last Name Of The Provider | WEBB-SOTO |
| First Name Of The Provider | CASONDRA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 CONTINENTAL PL |
| Street Address 2 Of The Provider | #101 |
| City Of The Provider | MOUNT VERNON |
| Zip Code Of The Provider | 982735607 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 4514 |
| Number Of Medicare Beneficiaries | 878 |
| Total Submitted Charge Amount | 511407 |
| Total Medicare Allowed Amount | 218049.03 |
| Total Medicare Payment Amount | 156504.45 |
| Total Medicare Standardized Payment Amount | 182049.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 144 |
| Total Drug Medicare AllowedAmount | 31.98 |
| Total Drug Medicare PaymentAmount | 24.12 |
| Total Drug Medicare Standardized Payment Amount | 24.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 4496 |
| Number Of Medicare Beneficiaries With Medical Services | 878 |
| Total Medical Submitted Charge Amount | 511263 |
| Total Medical Medicare Allowed Amount | 218017.05 |
| Total Medical Medicare Payment Amount | 156480.33 |
| Total Medical Medicare Standardized Payment Amount | 182025.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 451 |
| Number Of Beneficiaries Age 75 to 84 | 303 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 368 |
| Number Of Non Hispanic White Beneficiaries | 842 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 858 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 1 |
| Average HCC Risk Score Of Beneficiaries | 0.8247 |