| National Provider Identifier [NPI]: | 1407288863 |
| Last Name Of The Provider | MALLORY |
| First Name Of The Provider | LORI |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 CAPITOL BEACH BLVD STE 1A |
| Street Address 2 Of The Provider | |
| City Of The Provider | LINCOLN |
| Zip Code Of The Provider | 685281645 |
| 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 | 26 |
| Number Of Services | 216 |
| Number Of Medicare Beneficiaries | 87 |
| Total Submitted Charge Amount | 16959.58 |
| Total Medicare Allowed Amount | 8932.86 |
| Total Medicare Payment Amount | 6569.97 |
| Total Medicare Standardized Payment Amount | 8203.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 1524.58 |
| Total Drug Medicare AllowedAmount | 1354.76 |
| Total Drug Medicare PaymentAmount | 1325.35 |
| Total Drug Medicare Standardized Payment Amount | 1325.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 158 |
| Number Of Medicare Beneficiaries With Medical Services | 84 |
| Total Medical Submitted Charge Amount | 15435 |
| Total Medical Medicare Allowed Amount | 7578.1 |
| Total Medical Medicare Payment Amount | 5244.62 |
| Total Medical Medicare Standardized Payment Amount | 6878.44 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 48 |
| Number Of Male Beneficiaries | 39 |
| 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 | 67 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7236 |