| National Provider Identifier [NPI]: | 1821021098 |
| Last Name Of The Provider | IAKIRI |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 CHERRY ST SE |
| Street Address 2 Of The Provider | SUITE 2200 |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495034608 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 9215 |
| Number Of Medicare Beneficiaries | 64 |
| Total Submitted Charge Amount | 146753 |
| Total Medicare Allowed Amount | 89481.63 |
| Total Medicare Payment Amount | 69689.97 |
| Total Medicare Standardized Payment Amount | 70472.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 33 |
| Number Of Drug Services | 9095 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 134796 |
| Total Drug Medicare AllowedAmount | 83915.03 |
| Total Drug Medicare PaymentAmount | 65789.31 |
| Total Drug Medicare Standardized Payment Amount | 65789.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 120 |
| Number Of Medicare Beneficiaries With Medical Services | 64 |
| Total Medical Submitted Charge Amount | 11957 |
| Total Medical Medicare Allowed Amount | 5566.6 |
| Total Medical Medicare Payment Amount | 3900.66 |
| Total Medical Medicare Standardized Payment Amount | 4683.57 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | 15 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 32 |
| Number Of Male Beneficiaries | 32 |
| 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 | 52 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 48 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 2.7579 |