| National Provider Identifier [NPI]: | 1497746341 |
| Last Name Of The Provider | SHAVER |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 LILE CT |
| Street Address 2 Of The Provider | SUITE 102B |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722056221 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 7993 |
| Number Of Medicare Beneficiaries | 1050 |
| Total Submitted Charge Amount | 770620.8 |
| Total Medicare Allowed Amount | 595944.51 |
| Total Medicare Payment Amount | 448403.77 |
| Total Medicare Standardized Payment Amount | 484352.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2878 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 44858 |
| Total Drug Medicare AllowedAmount | 33061.38 |
| Total Drug Medicare PaymentAmount | 25336.1 |
| Total Drug Medicare Standardized Payment Amount | 25336.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 5115 |
| Number Of Medicare Beneficiaries With Medical Services | 1050 |
| Total Medical Submitted Charge Amount | 725762.8 |
| Total Medical Medicare Allowed Amount | 562883.13 |
| Total Medical Medicare Payment Amount | 423067.67 |
| Total Medical Medicare Standardized Payment Amount | 459016.74 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 230 |
| Number Of Beneficiaries Age 65 to 74 | 340 |
| Number Of Beneficiaries Age 75 to 84 | 312 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 556 |
| Number Of Male Beneficiaries | 494 |
| Number Of Non Hispanic White Beneficiaries | 847 |
| Number Of Black or African American Beneficiaries | 177 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 724 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 326 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 3.2646 |