| National Provider Identifier [NPI]: | 1790715126 |
| Last Name Of The Provider | LASALLE |
| First Name Of The Provider | SEAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 105 W 8TH AVE |
| Street Address 2 Of The Provider | STE 6080 |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042302 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 51752 |
| Number Of Medicare Beneficiaries | 688 |
| Total Submitted Charge Amount | 3243834.6 |
| Total Medicare Allowed Amount | 2263024.82 |
| Total Medicare Payment Amount | 1715538.41 |
| Total Medicare Standardized Payment Amount | 1714445.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 43635 |
| Number Of Medicare Beneficiaries With Drug Services | 257 |
| Total Drug Submitted ChargeAmount | 2615032.6 |
| Total Drug Medicare AllowedAmount | 1970810.89 |
| Total Drug Medicare PaymentAmount | 1493730.48 |
| Total Drug Medicare Standardized Payment Amount | 1493730.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 8117 |
| Number Of Medicare Beneficiaries With Medical Services | 683 |
| Total Medical Submitted Charge Amount | 628802 |
| Total Medical Medicare Allowed Amount | 292213.93 |
| Total Medical Medicare Payment Amount | 221807.93 |
| Total Medical Medicare Standardized Payment Amount | 220715.41 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 634 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 584 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1685 |