| National Provider Identifier [NPI]: | 1316961659 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1025 153RD ST SE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MILL CREEK |
| Zip Code Of The Provider | 980124051 |
| 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 | 38 |
| Number Of Services | 414 |
| Number Of Medicare Beneficiaries | 95 |
| Total Submitted Charge Amount | 55265 |
| Total Medicare Allowed Amount | 26721.04 |
| Total Medicare Payment Amount | 18575.17 |
| Total Medicare Standardized Payment Amount | 19420.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 97 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 2865 |
| Total Drug Medicare AllowedAmount | 2035.83 |
| Total Drug Medicare PaymentAmount | 1951.39 |
| Total Drug Medicare Standardized Payment Amount | 1951.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 317 |
| Number Of Medicare Beneficiaries With Medical Services | 95 |
| Total Medical Submitted Charge Amount | 52400 |
| Total Medical Medicare Allowed Amount | 24685.21 |
| Total Medical Medicare Payment Amount | 16623.78 |
| Total Medical Medicare Standardized Payment Amount | 17469.39 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | 16 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 35 |
| Number Of Male Beneficiaries | 60 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7925 |