| National Provider Identifier [NPI]: | 1447210778 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | CATHERINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | N. P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7916 W JEFFERSON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468044140 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 735 |
| Number Of Medicare Beneficiaries | 445 |
| Total Submitted Charge Amount | 97440 |
| Total Medicare Allowed Amount | 44020.63 |
| Total Medicare Payment Amount | 31596.61 |
| Total Medicare Standardized Payment Amount | 41674.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 4018 |
| Total Drug Medicare AllowedAmount | 1849.26 |
| Total Drug Medicare PaymentAmount | 1812.26 |
| Total Drug Medicare Standardized Payment Amount | 1812.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 722 |
| Number Of Medicare Beneficiaries With Medical Services | 445 |
| Total Medical Submitted Charge Amount | 93422 |
| Total Medical Medicare Allowed Amount | 42171.37 |
| Total Medical Medicare Payment Amount | 29784.35 |
| Total Medical Medicare Standardized Payment Amount | 39862.28 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 189 |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 239 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 406 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 365 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 26 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 56 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6476 |