| National Provider Identifier [NPI]: | 1487869129 |
| Last Name Of The Provider | NELLI |
| First Name Of The Provider | ERIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 910 W 5TH AVE STE 700 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042967 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 190 |
| Number Of Services | 48571 |
| Number Of Medicare Beneficiaries | 431 |
| Total Submitted Charge Amount | 2471381.96 |
| Total Medicare Allowed Amount | 1051207.49 |
| Total Medicare Payment Amount | 806101.96 |
| Total Medicare Standardized Payment Amount | 807093.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 80 |
| Number Of Drug Services | 45360 |
| Number Of Medicare Beneficiaries With Drug Services | 238 |
| Total Drug Submitted ChargeAmount | 1975926.75 |
| Total Drug Medicare AllowedAmount | 881187.23 |
| Total Drug Medicare PaymentAmount | 673451.13 |
| Total Drug Medicare Standardized Payment Amount | 673451.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 3211 |
| Number Of Medicare Beneficiaries With Medical Services | 430 |
| Total Medical Submitted Charge Amount | 495455.21 |
| Total Medical Medicare Allowed Amount | 170020.26 |
| Total Medical Medicare Payment Amount | 132650.83 |
| Total Medical Medicare Standardized Payment Amount | 133642.35 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 411 |
| 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 | 373 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.6902 |