| National Provider Identifier [NPI]: | 1821139957 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | ESTHER |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PHYSICIAN ASSISTANT |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1005 MAR WALT DRIVE |
| Street Address 2 Of The Provider | INTERNAL MEDICINE DEPARTMENT |
| City Of The Provider | FORT WALTON BEACH |
| Zip Code Of The Provider | 325476796 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 182 |
| Number Of Medicare Beneficiaries | 84 |
| Total Submitted Charge Amount | 17290 |
| Total Medicare Allowed Amount | 8212.6 |
| Total Medicare Payment Amount | 6585.13 |
| Total Medicare Standardized Payment Amount | 7700.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 2345 |
| Total Drug Medicare AllowedAmount | 1373.59 |
| Total Drug Medicare PaymentAmount | 1169.88 |
| Total Drug Medicare Standardized Payment Amount | 1169.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 101 |
| Number Of Medicare Beneficiaries With Medical Services | 77 |
| Total Medical Submitted Charge Amount | 14945 |
| Total Medical Medicare Allowed Amount | 6839.01 |
| Total Medical Medicare Payment Amount | 5415.25 |
| Total Medical Medicare Standardized Payment Amount | 6530.4 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 27 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 29 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1206 |