| National Provider Identifier [NPI]: | 1437120128 |
| Last Name Of The Provider | MACNAK |
| First Name Of The Provider | KATHY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MSN, FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 888 GRAHAM DR |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | TOMBALL |
| Zip Code Of The Provider | 773753322 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 934 |
| Number Of Medicare Beneficiaries | 307 |
| Total Submitted Charge Amount | 266571.05 |
| Total Medicare Allowed Amount | 98939.51 |
| Total Medicare Payment Amount | 73447.7 |
| Total Medicare Standardized Payment Amount | 83289.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 3200 |
| Total Drug Medicare AllowedAmount | 492.8 |
| Total Drug Medicare PaymentAmount | 482.88 |
| Total Drug Medicare Standardized Payment Amount | 482.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 902 |
| Number Of Medicare Beneficiaries With Medical Services | 307 |
| Total Medical Submitted Charge Amount | 263371.05 |
| Total Medical Medicare Allowed Amount | 98446.71 |
| Total Medical Medicare Payment Amount | 72964.82 |
| Total Medical Medicare Standardized Payment Amount | 82806.64 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 230 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 260 |
| Number Of Black or African American Beneficiaries | 24 |
| 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 | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 2.4142 |