| National Provider Identifier [NPI]: | 1063598787 |
| Last Name Of The Provider | O'KANE |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1355 N 205TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHORELINE |
| Zip Code Of The Provider | 981333215 |
| 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 | 56 |
| Number Of Services | 1153 |
| Number Of Medicare Beneficiaries | 266 |
| Total Submitted Charge Amount | 91040.44 |
| Total Medicare Allowed Amount | 47827 |
| Total Medicare Payment Amount | 31610.86 |
| Total Medicare Standardized Payment Amount | 29809.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 421 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 2887.46 |
| Total Drug Medicare AllowedAmount | 1949.08 |
| Total Drug Medicare PaymentAmount | 1886.49 |
| Total Drug Medicare Standardized Payment Amount | 1886.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 732 |
| Number Of Medicare Beneficiaries With Medical Services | 265 |
| Total Medical Submitted Charge Amount | 88152.98 |
| Total Medical Medicare Allowed Amount | 45877.92 |
| Total Medical Medicare Payment Amount | 29724.37 |
| Total Medical Medicare Standardized Payment Amount | 27923.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 213 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1053 |