| National Provider Identifier [NPI]: | 1841391869 |
| Last Name Of The Provider | GASQUE |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 503 W COLLEGE STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLORENCE |
| Zip Code Of The Provider | 356301740 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 602 |
| Number Of Medicare Beneficiaries | 102 |
| Total Submitted Charge Amount | 57037 |
| Total Medicare Allowed Amount | 34011.05 |
| Total Medicare Payment Amount | 25580.49 |
| Total Medicare Standardized Payment Amount | 32572.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 172 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 3237 |
| Total Drug Medicare AllowedAmount | 361.04 |
| Total Drug Medicare PaymentAmount | 312.98 |
| Total Drug Medicare Standardized Payment Amount | 312.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 430 |
| Number Of Medicare Beneficiaries With Medical Services | 102 |
| Total Medical Submitted Charge Amount | 53800 |
| Total Medical Medicare Allowed Amount | 33650.01 |
| Total Medical Medicare Payment Amount | 25267.51 |
| Total Medical Medicare Standardized Payment Amount | 32259.88 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 76 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 27 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| 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 | |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.131 |