| National Provider Identifier [NPI]: | 1649540055 |
| Last Name Of The Provider | HAHN |
| First Name Of The Provider | VICKI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 145 MICHIGAN ST NE |
| Street Address 2 Of The Provider | SUITE 3100 |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495032562 |
| 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 | 49 |
| Number Of Services | 3715 |
| Number Of Medicare Beneficiaries | 56 |
| Total Submitted Charge Amount | 102631.6 |
| Total Medicare Allowed Amount | 66086.61 |
| Total Medicare Payment Amount | 51402.29 |
| Total Medicare Standardized Payment Amount | 52378.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 3610 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 89492.1 |
| Total Drug Medicare AllowedAmount | 60641.42 |
| Total Drug Medicare PaymentAmount | 47443.31 |
| Total Drug Medicare Standardized Payment Amount | 47443.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 105 |
| Number Of Medicare Beneficiaries With Medical Services | 56 |
| Total Medical Submitted Charge Amount | 13139.5 |
| Total Medical Medicare Allowed Amount | 5445.19 |
| Total Medical Medicare Payment Amount | 3958.98 |
| Total Medical Medicare Standardized Payment Amount | 4935.52 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | 14 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 28 |
| Number Of Male Beneficiaries | 28 |
| 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 | 44 |
| 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 | 25 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.4088 |