| National Provider Identifier [NPI]: | 1164488144 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | ANNETTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 234 W CENTRAL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | JAMESTOWN |
| Zip Code Of The Provider | 385563405 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 15091 |
| Number Of Medicare Beneficiaries | 700 |
| Total Submitted Charge Amount | 541807 |
| Total Medicare Allowed Amount | 263331.02 |
| Total Medicare Payment Amount | 194752.04 |
| Total Medicare Standardized Payment Amount | 235063.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 4146 |
| Number Of Medicare Beneficiaries With Drug Services | 477 |
| Total Drug Submitted ChargeAmount | 56853 |
| Total Drug Medicare AllowedAmount | 18079.54 |
| Total Drug Medicare PaymentAmount | 14644.28 |
| Total Drug Medicare Standardized Payment Amount | 14644.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 10945 |
| Number Of Medicare Beneficiaries With Medical Services | 700 |
| Total Medical Submitted Charge Amount | 484954 |
| Total Medical Medicare Allowed Amount | 245251.48 |
| Total Medical Medicare Payment Amount | 180107.76 |
| Total Medical Medicare Standardized Payment Amount | 220419.57 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 332 |
| Number Of Beneficiaries Age 75 to 84 | 152 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 276 |
| 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 | 359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 341 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3214 |