| National Provider Identifier [NPI]: | 1619004942 |
| Last Name Of The Provider | REVOIR |
| First Name Of The Provider | EDITH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6200 REGIONAL PLZ |
| Street Address 2 Of The Provider | SUITE 1200 |
| City Of The Provider | ABILENE |
| Zip Code Of The Provider | 796065250 |
| 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 | 76 |
| Number Of Services | 4114 |
| Number Of Medicare Beneficiaries | 623 |
| Total Submitted Charge Amount | 138053 |
| Total Medicare Allowed Amount | 62524.04 |
| Total Medicare Payment Amount | 42773.59 |
| Total Medicare Standardized Payment Amount | 51366.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 2471 |
| Number Of Medicare Beneficiaries With Drug Services | 400 |
| Total Drug Submitted ChargeAmount | 16925 |
| Total Drug Medicare AllowedAmount | 3246.72 |
| Total Drug Medicare PaymentAmount | 2333.53 |
| Total Drug Medicare Standardized Payment Amount | 2333.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 1643 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 121128 |
| Total Medical Medicare Allowed Amount | 59277.32 |
| Total Medical Medicare Payment Amount | 40440.06 |
| Total Medical Medicare Standardized Payment Amount | 49032.91 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 240 |
| Number Of Beneficiaries Age 75 to 84 | 196 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 381 |
| Number Of Male Beneficiaries | 242 |
| Number Of Non Hispanic White Beneficiaries | 547 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 142 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0941 |