| National Provider Identifier [NPI]: | 1497927297 |
| Last Name Of The Provider | CLARKSON |
| First Name Of The Provider | KATIE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MSN, ARNP, BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1813 SUMNER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ABERDEEN |
| Zip Code Of The Provider | 985204600 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 702 |
| Number Of Medicare Beneficiaries | 181 |
| Total Submitted Charge Amount | 12574.58 |
| Total Medicare Allowed Amount | 8114.05 |
| Total Medicare Payment Amount | 7643.98 |
| Total Medicare Standardized Payment Amount | 7772.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 1426.12 |
| Total Drug Medicare AllowedAmount | 1368.49 |
| Total Drug Medicare PaymentAmount | 1335.14 |
| Total Drug Medicare Standardized Payment Amount | 1335.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 622 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 11148.46 |
| Total Medical Medicare Allowed Amount | 6745.56 |
| Total Medical Medicare Payment Amount | 6308.84 |
| Total Medical Medicare Standardized Payment Amount | 6437.58 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 150 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 45 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1199 |