| National Provider Identifier [NPI]: | 1053684332 |
| Last Name Of The Provider | ADDISON |
| First Name Of The Provider | SAMANTHA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 280 VIRGINIA AVE NE |
| Street Address 2 Of The Provider | SUITE 107 |
| City Of The Provider | NORTON |
| Zip Code Of The Provider | 242731538 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1514 |
| Number Of Medicare Beneficiaries | 468 |
| Total Submitted Charge Amount | 217562 |
| Total Medicare Allowed Amount | 65311.02 |
| Total Medicare Payment Amount | 47059.81 |
| Total Medicare Standardized Payment Amount | 56540.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 546 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 5102 |
| Total Drug Medicare AllowedAmount | 1338.44 |
| Total Drug Medicare PaymentAmount | 1199.74 |
| Total Drug Medicare Standardized Payment Amount | 1199.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 968 |
| Number Of Medicare Beneficiaries With Medical Services | 467 |
| Total Medical Submitted Charge Amount | 212460 |
| Total Medical Medicare Allowed Amount | 63972.58 |
| Total Medical Medicare Payment Amount | 45860.07 |
| Total Medical Medicare Standardized Payment Amount | 55341.05 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 168 |
| Number Of Beneficiaries Age 65 to 74 | 157 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 452 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 182 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3448 |