| National Provider Identifier [NPI]: | 1992134241 |
| Last Name Of The Provider | NOBLES |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2408 HEATHROW DR |
| Street Address 2 Of The Provider | APARTMENT 14 |
| City Of The Provider | CHAMPAIGN |
| Zip Code Of The Provider | 618202385 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 273 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 123675 |
| Total Medicare Allowed Amount | 21268.48 |
| Total Medicare Payment Amount | 14998 |
| Total Medicare Standardized Payment Amount | 17957.33 |
| 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 | 14 |
| Number Of Medical Services | 273 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 123675 |
| Total Medical Medicare Allowed Amount | 21268.48 |
| Total Medical Medicare Payment Amount | 14998 |
| Total Medical Medicare Standardized Payment Amount | 17957.33 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| 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 | 97 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 141 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6582 |