| National Provider Identifier [NPI]: | 1699054106 |
| Last Name Of The Provider | WOLFE |
| First Name Of The Provider | LESLIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2116 W FAIDLEY AVE |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | GRAND ISLAND |
| Zip Code Of The Provider | 688034678 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1034 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 59956.5 |
| Total Medicare Allowed Amount | 30608.36 |
| Total Medicare Payment Amount | 21534.99 |
| Total Medicare Standardized Payment Amount | 28291.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 216 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 1539.5 |
| Total Drug Medicare AllowedAmount | 911.58 |
| Total Drug Medicare PaymentAmount | 780.49 |
| Total Drug Medicare Standardized Payment Amount | 780.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 818 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 58417 |
| Total Medical Medicare Allowed Amount | 29696.78 |
| Total Medical Medicare Payment Amount | 20754.5 |
| Total Medical Medicare Standardized Payment Amount | 27510.62 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 125 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 187 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0196 |