| National Provider Identifier [NPI]: | 1760596647 |
| Last Name Of The Provider | ANDREW |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 PRUDENTIAL DR STE 304 |
| Street Address 2 Of The Provider | CREDENTIALING DEPARTMENT |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322078205 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 2012 |
| Number Of Medicare Beneficiaries | 379 |
| Total Submitted Charge Amount | 287489 |
| Total Medicare Allowed Amount | 170131.27 |
| Total Medicare Payment Amount | 133127.16 |
| Total Medicare Standardized Payment Amount | 132365.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 2012 |
| Number Of Medicare Beneficiaries With Medical Services | 379 |
| Total Medical Submitted Charge Amount | 287489 |
| Total Medical Medicare Allowed Amount | 170131.27 |
| Total Medical Medicare Payment Amount | 133127.16 |
| Total Medical Medicare Standardized Payment Amount | 132365.07 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 325 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 318 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 63 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 44 |
| Average HCC Risk Score Of Beneficiaries | 2.4143 |