| National Provider Identifier [NPI]: | 1205179066 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | KATHRYN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2510 EL CAMINO REAL |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARLSBAD |
| Zip Code Of The Provider | 920081273 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 470 |
| Number Of Medicare Beneficiaries | 259 |
| Total Submitted Charge Amount | 17931.17 |
| Total Medicare Allowed Amount | 16925.48 |
| Total Medicare Payment Amount | 13648.15 |
| Total Medicare Standardized Payment Amount | 15533.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 183 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 5647.17 |
| Total Drug Medicare AllowedAmount | 5528.61 |
| Total Drug Medicare PaymentAmount | 5402.34 |
| Total Drug Medicare Standardized Payment Amount | 5402.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 287 |
| Number Of Medicare Beneficiaries With Medical Services | 259 |
| Total Medical Submitted Charge Amount | 12284 |
| Total Medical Medicare Allowed Amount | 11396.87 |
| Total Medical Medicare Payment Amount | 8245.81 |
| Total Medical Medicare Standardized Payment Amount | 10131.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 142 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 165 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | 235 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 246 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8291 |