| National Provider Identifier [NPI]: | 1528051182 |
| Last Name Of The Provider | EVERSMANN |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3106 OUTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARION |
| Zip Code Of The Provider | 629595270 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1298 |
| Number Of Medicare Beneficiaries | 308 |
| Total Submitted Charge Amount | 82716.5 |
| Total Medicare Allowed Amount | 32231.77 |
| Total Medicare Payment Amount | 20468.58 |
| Total Medicare Standardized Payment Amount | 25856.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 693 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 15780.5 |
| Total Drug Medicare AllowedAmount | 1839.65 |
| Total Drug Medicare PaymentAmount | 1164.56 |
| Total Drug Medicare Standardized Payment Amount | 1164.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 605 |
| Number Of Medicare Beneficiaries With Medical Services | 308 |
| Total Medical Submitted Charge Amount | 66936 |
| Total Medical Medicare Allowed Amount | 30392.12 |
| Total Medical Medicare Payment Amount | 19304.02 |
| Total Medical Medicare Standardized Payment Amount | 24692.24 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 257 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1252 |