| National Provider Identifier [NPI]: | 1629353537 |
| Last Name Of The Provider | FEDEWA |
| First Name Of The Provider | AARON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | NP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2332 ALPINE AVE NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495441955 |
| 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 | 26 |
| Number Of Services | 294.5 |
| Number Of Medicare Beneficiaries | 109 |
| Total Submitted Charge Amount | 36966.5 |
| Total Medicare Allowed Amount | 17823.06 |
| Total Medicare Payment Amount | 12422.14 |
| Total Medicare Standardized Payment Amount | 15460.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 40.5 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 835.5 |
| Total Drug Medicare AllowedAmount | 557 |
| Total Drug Medicare PaymentAmount | 531.9 |
| Total Drug Medicare Standardized Payment Amount | 531.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 254 |
| Number Of Medicare Beneficiaries With Medical Services | 109 |
| Total Medical Submitted Charge Amount | 36131 |
| Total Medical Medicare Allowed Amount | 17266.06 |
| Total Medical Medicare Payment Amount | 11890.24 |
| Total Medical Medicare Standardized Payment Amount | 14928.35 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| 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 | 73 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3326 |