| National Provider Identifier [NPI]: | 1952380859 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3707 BRAMBLETON AVE SW |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 24018 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 706 |
| Number Of Medicare Beneficiaries | 268 |
| Total Submitted Charge Amount | 55029 |
| Total Medicare Allowed Amount | 35849.42 |
| Total Medicare Payment Amount | 25224.93 |
| Total Medicare Standardized Payment Amount | 30868.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 90 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 1503 |
| Total Drug Medicare AllowedAmount | 950.46 |
| Total Drug Medicare PaymentAmount | 909.8 |
| Total Drug Medicare Standardized Payment Amount | 909.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 616 |
| Number Of Medicare Beneficiaries With Medical Services | 268 |
| Total Medical Submitted Charge Amount | 53526 |
| Total Medical Medicare Allowed Amount | 34898.96 |
| Total Medical Medicare Payment Amount | 24315.13 |
| Total Medical Medicare Standardized Payment Amount | 29958.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 177 |
| Number Of Male Beneficiaries | 91 |
| 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 | 252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8148 |