| National Provider Identifier [NPI]: | 1437238938 |
| Last Name Of The Provider | BAIN |
| First Name Of The Provider | LAQUITA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 502 ALCORN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORINTH |
| Zip Code Of The Provider | 38834 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 4326 |
| Number Of Medicare Beneficiaries | 447 |
| Total Submitted Charge Amount | 224375 |
| Total Medicare Allowed Amount | 82131.48 |
| Total Medicare Payment Amount | 59451.54 |
| Total Medicare Standardized Payment Amount | 75736.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1465 |
| Number Of Medicare Beneficiaries With Drug Services | 163 |
| Total Drug Submitted ChargeAmount | 26580 |
| Total Drug Medicare AllowedAmount | 691.84 |
| Total Drug Medicare PaymentAmount | 540.78 |
| Total Drug Medicare Standardized Payment Amount | 540.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 2861 |
| Number Of Medicare Beneficiaries With Medical Services | 447 |
| Total Medical Submitted Charge Amount | 197795 |
| Total Medical Medicare Allowed Amount | 81439.64 |
| Total Medical Medicare Payment Amount | 58910.76 |
| Total Medical Medicare Standardized Payment Amount | 75195.94 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 159 |
| Number Of Beneficiaries Age 65 to 74 | 172 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 189 |
| Number Of Non Hispanic White Beneficiaries | 392 |
| 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 | 245 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 202 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.176 |