| National Provider Identifier [NPI]: | 1699929513 |
| Last Name Of The Provider | BEHM |
| First Name Of The Provider | GWEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 LUTHER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CROWN POINT |
| Zip Code Of The Provider | 463075043 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 305 |
| Number Of Medicare Beneficiaries | 110 |
| Total Submitted Charge Amount | 22181 |
| Total Medicare Allowed Amount | 14298.84 |
| Total Medicare Payment Amount | 9792.72 |
| Total Medicare Standardized Payment Amount | 12589.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1548 |
| Total Drug Medicare AllowedAmount | 363.39 |
| Total Drug Medicare PaymentAmount | 343.38 |
| Total Drug Medicare Standardized Payment Amount | 343.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 262 |
| Number Of Medicare Beneficiaries With Medical Services | 110 |
| Total Medical Submitted Charge Amount | 20633 |
| Total Medical Medicare Allowed Amount | 13935.45 |
| Total Medical Medicare Payment Amount | 9449.34 |
| Total Medical Medicare Standardized Payment Amount | 12246.39 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | 89 |
| 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 | 93 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1237 |