| National Provider Identifier [NPI]: | 1285638262 |
| Last Name Of The Provider | MILLER |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | APN/CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 N STATE HIGHWAY 121 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MT ZION |
| Zip Code Of The Provider | 625491224 |
| 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 | 28 |
| Number Of Services | 656 |
| Number Of Medicare Beneficiaries | 232 |
| Total Submitted Charge Amount | 71883 |
| Total Medicare Allowed Amount | 31282.83 |
| Total Medicare Payment Amount | 21305.33 |
| Total Medicare Standardized Payment Amount | 26848.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1059 |
| Total Drug Medicare AllowedAmount | 753.01 |
| Total Drug Medicare PaymentAmount | 736.47 |
| Total Drug Medicare Standardized Payment Amount | 736.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 638 |
| Number Of Medicare Beneficiaries With Medical Services | 232 |
| Total Medical Submitted Charge Amount | 70824 |
| Total Medical Medicare Allowed Amount | 30529.82 |
| Total Medical Medicare Payment Amount | 20568.86 |
| Total Medical Medicare Standardized Payment Amount | 26112.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 71 |
| 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 | 214 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8333 |