| National Provider Identifier [NPI]: | 1306002639 |
| Last Name Of The Provider | HOLT-KNOX |
| First Name Of The Provider | SARA |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 EASTSIDE STREET |
| Street Address 2 Of The Provider | EASTSIDE WOMEN'S HEALTH |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 98501 |
| 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 | 29 |
| Number Of Services | 289 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 7579.51 |
| Total Medicare Allowed Amount | 5161.37 |
| Total Medicare Payment Amount | 4436.78 |
| Total Medicare Standardized Payment Amount | 4700.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 636.71 |
| Total Drug Medicare AllowedAmount | 606.3 |
| Total Drug Medicare PaymentAmount | 584.13 |
| Total Drug Medicare Standardized Payment Amount | 584.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 254 |
| Number Of Medicare Beneficiaries With Medical Services | 91 |
| Total Medical Submitted Charge Amount | 6942.8 |
| Total Medical Medicare Allowed Amount | 4555.07 |
| Total Medical Medicare Payment Amount | 3852.65 |
| Total Medical Medicare Standardized Payment Amount | 4116.08 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 62 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 80 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0345 |