| National Provider Identifier [NPI]: | 1679919062 |
| Last Name Of The Provider | CHAMP |
| First Name Of The Provider | LAURIE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5844 NW BARRY RD |
| Street Address 2 Of The Provider | STE. 110 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641541465 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 1240 |
| Number Of Medicare Beneficiaries | 78 |
| Total Submitted Charge Amount | 204320 |
| Total Medicare Allowed Amount | 81249.11 |
| Total Medicare Payment Amount | 61374.3 |
| Total Medicare Standardized Payment Amount | 69464.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 300 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 54000 |
| Total Drug Medicare AllowedAmount | 27074.57 |
| Total Drug Medicare PaymentAmount | 21004.23 |
| Total Drug Medicare Standardized Payment Amount | 21004.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 940 |
| Number Of Medicare Beneficiaries With Medical Services | 78 |
| Total Medical Submitted Charge Amount | 150320 |
| Total Medical Medicare Allowed Amount | 54174.54 |
| Total Medical Medicare Payment Amount | 40370.07 |
| Total Medical Medicare Standardized Payment Amount | 48459.93 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 53 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| 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 | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1067 |