| National Provider Identifier [NPI]: | 1194004150 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | DUSTIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3330 CHURN CREEK RD |
| Street Address 2 Of The Provider | SUITE D4 |
| City Of The Provider | REDDING |
| Zip Code Of The Provider | 960022532 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 920 |
| Number Of Medicare Beneficiaries | 213 |
| Total Submitted Charge Amount | 69478 |
| Total Medicare Allowed Amount | 51838.2 |
| Total Medicare Payment Amount | 39741.3 |
| Total Medicare Standardized Payment Amount | 44874.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 184 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 3225 |
| Total Drug Medicare AllowedAmount | 1271.25 |
| Total Drug Medicare PaymentAmount | 1093.28 |
| Total Drug Medicare Standardized Payment Amount | 1093.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 736 |
| Number Of Medicare Beneficiaries With Medical Services | 213 |
| Total Medical Submitted Charge Amount | 66253 |
| Total Medical Medicare Allowed Amount | 50566.95 |
| Total Medical Medicare Payment Amount | 38648.02 |
| Total Medical Medicare Standardized Payment Amount | 43781.28 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | 198 |
| 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 | 179 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8952 |