| National Provider Identifier [NPI]: | 1235481771 |
| Last Name Of The Provider | VANDIVER |
| First Name Of The Provider | KATHERYN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1040 SW 19TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOORE |
| Zip Code Of The Provider | 73160 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 996 |
| Number Of Medicare Beneficiaries | 418 |
| Total Submitted Charge Amount | 85607.94 |
| Total Medicare Allowed Amount | 33387.26 |
| Total Medicare Payment Amount | 26856.22 |
| Total Medicare Standardized Payment Amount | 31851.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 320 |
| Number Of Medicare Beneficiaries With Drug Services | 288 |
| Total Drug Submitted ChargeAmount | 9712.08 |
| Total Drug Medicare AllowedAmount | 8558.97 |
| Total Drug Medicare PaymentAmount | 8275.76 |
| Total Drug Medicare Standardized Payment Amount | 8275.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 676 |
| Number Of Medicare Beneficiaries With Medical Services | 415 |
| Total Medical Submitted Charge Amount | 75895.86 |
| Total Medical Medicare Allowed Amount | 24828.29 |
| Total Medical Medicare Payment Amount | 18580.46 |
| Total Medical Medicare Standardized Payment Amount | 23576.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 218 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 253 |
| Number Of Male Beneficiaries | 165 |
| Number Of Non Hispanic White Beneficiaries | 373 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7428 |