| National Provider Identifier [NPI]: | 1083895346 |
| Last Name Of The Provider | HSIE |
| First Name Of The Provider | TADD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1455 11TH AVE NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ISSAQUAH |
| Zip Code Of The Provider | 980275319 |
| 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 | 45 |
| Number Of Services | 937 |
| Number Of Medicare Beneficiaries | 235 |
| Total Submitted Charge Amount | 118519.14 |
| Total Medicare Allowed Amount | 62132.22 |
| Total Medicare Payment Amount | 43803.12 |
| Total Medicare Standardized Payment Amount | 40776.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 2725.2 |
| Total Drug Medicare AllowedAmount | 2056.94 |
| Total Drug Medicare PaymentAmount | 2014.49 |
| Total Drug Medicare Standardized Payment Amount | 2014.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 864 |
| Number Of Medicare Beneficiaries With Medical Services | 234 |
| Total Medical Submitted Charge Amount | 115793.94 |
| Total Medical Medicare Allowed Amount | 60075.28 |
| Total Medical Medicare Payment Amount | 41788.63 |
| Total Medical Medicare Standardized Payment Amount | 38762.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 121 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 73 |
| 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 | 151 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9514 |