| National Provider Identifier [NPI]: | 1316900632 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | TERRI |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 S STEVENS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042654 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 10517 |
| Number Of Medicare Beneficiaries | 2549 |
| Total Submitted Charge Amount | 512947.52 |
| Total Medicare Allowed Amount | 152260.3 |
| Total Medicare Payment Amount | 112490.09 |
| Total Medicare Standardized Payment Amount | 113657.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7390 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 3686.4 |
| Total Drug Medicare AllowedAmount | 1438.21 |
| Total Drug Medicare PaymentAmount | 1109.85 |
| Total Drug Medicare Standardized Payment Amount | 1109.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 3127 |
| Number Of Medicare Beneficiaries With Medical Services | 2549 |
| Total Medical Submitted Charge Amount | 509261.12 |
| Total Medical Medicare Allowed Amount | 150822.09 |
| Total Medical Medicare Payment Amount | 111380.24 |
| Total Medical Medicare Standardized Payment Amount | 112547.41 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 474 |
| Number Of Beneficiaries Age 65 to 74 | 941 |
| Number Of Beneficiaries Age 75 to 84 | 728 |
| Number Of Beneficiaries Age Greater 84 | 406 |
| Number Of Female Beneficiaries | 1402 |
| Number Of Male Beneficiaries | 1147 |
| Number Of Non Hispanic White Beneficiaries | 2334 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | 48 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1929 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 620 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7467 |