| National Provider Identifier [NPI]: | 1992062574 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1009 N DIXIE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELIZABETHTOWN |
| Zip Code Of The Provider | 427012521 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 577 |
| Number Of Medicare Beneficiaries | 138 |
| Total Submitted Charge Amount | 58429 |
| Total Medicare Allowed Amount | 30267.5 |
| Total Medicare Payment Amount | 21737.28 |
| Total Medicare Standardized Payment Amount | 27532.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1295 |
| Total Drug Medicare AllowedAmount | 400.16 |
| Total Drug Medicare PaymentAmount | 382.93 |
| Total Drug Medicare Standardized Payment Amount | 382.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 548 |
| Number Of Medicare Beneficiaries With Medical Services | 138 |
| Total Medical Submitted Charge Amount | 57134 |
| Total Medical Medicare Allowed Amount | 29867.34 |
| Total Medical Medicare Payment Amount | 21354.35 |
| Total Medical Medicare Standardized Payment Amount | 27149.97 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 93 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 118 |
| 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 | 55 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9896 |