National Provider Identifier [NPI]: |
1942211941 |
Last Name Of The Provider |
TEERINK |
First Name Of The Provider |
ANNE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
311 S 72ND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
YAKIMA |
Zip Code Of The Provider |
98908 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
666 |
Number Of Medicare Beneficiaries |
187 |
Total Submitted Charge Amount |
76127.87 |
Total Medicare Allowed Amount |
47830.37 |
Total Medicare Payment Amount |
31471.88 |
Total Medicare Standardized Payment Amount |
31972.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
98 |
Number Of Medicare Beneficiaries With Drug Services |
48 |
Total Drug Submitted ChargeAmount |
1621.5 |
Total Drug Medicare AllowedAmount |
866.26 |
Total Drug Medicare PaymentAmount |
812.62 |
Total Drug Medicare Standardized Payment Amount |
812.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
568 |
Number Of Medicare Beneficiaries With Medical Services |
187 |
Total Medical Submitted Charge Amount |
74506.37 |
Total Medical Medicare Allowed Amount |
46964.11 |
Total Medical Medicare Payment Amount |
30659.26 |
Total Medical Medicare Standardized Payment Amount |
31159.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
18 |
Number Of Non Hispanic White Beneficiaries |
175 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
166 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
22 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8959 |