| National Provider Identifier [NPI]: | 1598952533 |
| Last Name Of The Provider | ROYSTON |
| First Name Of The Provider | SALLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | RN,MSN,FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 635 N ERIE ST |
| Street Address 2 Of The Provider | TOLEDO-LUCAS HEALTH DEPT ATTN BILLING RM 272 |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 43604 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 280 |
| Number Of Medicare Beneficiaries | 107 |
| Total Submitted Charge Amount | 22312 |
| Total Medicare Allowed Amount | 12166.49 |
| Total Medicare Payment Amount | 9128.31 |
| Total Medicare Standardized Payment Amount | 10973.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 823 |
| Total Drug Medicare AllowedAmount | 420.9 |
| Total Drug Medicare PaymentAmount | 387.3 |
| Total Drug Medicare Standardized Payment Amount | 387.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 251 |
| Number Of Medicare Beneficiaries With Medical Services | 107 |
| Total Medical Submitted Charge Amount | 21489 |
| Total Medical Medicare Allowed Amount | 11745.59 |
| Total Medical Medicare Payment Amount | 8741.01 |
| Total Medical Medicare Standardized Payment Amount | 10586.15 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 48 |
| 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 | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| 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 | 12 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8926 |