| National Provider Identifier [NPI]: | 1306870811 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | REBECCA |
| 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 | 803 N 5TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALPINE |
| Zip Code Of The Provider | 798303001 |
| 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 | 38 |
| Number Of Services | 1648 |
| Number Of Medicare Beneficiaries | 76 |
| Total Submitted Charge Amount | 67222.99 |
| Total Medicare Allowed Amount | 32422.08 |
| Total Medicare Payment Amount | 21760.08 |
| Total Medicare Standardized Payment Amount | 26693.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 776 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 10890.01 |
| Total Drug Medicare AllowedAmount | 1342.11 |
| Total Drug Medicare PaymentAmount | 1121.31 |
| Total Drug Medicare Standardized Payment Amount | 1121.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 872 |
| Number Of Medicare Beneficiaries With Medical Services | 76 |
| Total Medical Submitted Charge Amount | 56332.98 |
| Total Medical Medicare Allowed Amount | 31079.97 |
| Total Medical Medicare Payment Amount | 20638.77 |
| Total Medical Medicare Standardized Payment Amount | 25571.83 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 40 |
| 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 | 54 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8834 |