| National Provider Identifier [NPI]: | 1205149853 |
| Last Name Of The Provider | ACQUAVIVA |
| First Name Of The Provider | LYNN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 EMRICK BLVD |
| Street Address 2 Of The Provider | SUITE100 |
| City Of The Provider | BETHLEHEM |
| Zip Code Of The Provider | 180208040 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 267 |
| Number Of Medicare Beneficiaries | 118 |
| Total Submitted Charge Amount | 40864 |
| Total Medicare Allowed Amount | 20715.17 |
| Total Medicare Payment Amount | 14293.86 |
| Total Medicare Standardized Payment Amount | 15073.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 1115 |
| Total Drug Medicare AllowedAmount | 657.08 |
| Total Drug Medicare PaymentAmount | 635.19 |
| Total Drug Medicare Standardized Payment Amount | 635.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 245 |
| Number Of Medicare Beneficiaries With Medical Services | 118 |
| Total Medical Submitted Charge Amount | 39749 |
| Total Medical Medicare Allowed Amount | 20058.09 |
| Total Medical Medicare Payment Amount | 13658.67 |
| Total Medical Medicare Standardized Payment Amount | 14438.27 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 83 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | 93 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2179 |