| National Provider Identifier [NPI]: | 1437469822 |
| Last Name Of The Provider | ROBELLA |
| First Name Of The Provider | HEIDI |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28 MIDWAY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRISTOL |
| Zip Code Of The Provider | 376201706 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 183 |
| Number Of Medicare Beneficiaries | 74 |
| Total Submitted Charge Amount | 21690 |
| Total Medicare Allowed Amount | 10367.79 |
| Total Medicare Payment Amount | 7270.84 |
| Total Medicare Standardized Payment Amount | 9567.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 955 |
| Total Drug Medicare AllowedAmount | 110.17 |
| Total Drug Medicare PaymentAmount | 68.57 |
| Total Drug Medicare Standardized Payment Amount | 68.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 159 |
| Number Of Medicare Beneficiaries With Medical Services | 74 |
| Total Medical Submitted Charge Amount | 20735 |
| Total Medical Medicare Allowed Amount | 10257.62 |
| Total Medical Medicare Payment Amount | 7202.27 |
| Total Medical Medicare Standardized Payment Amount | 9499.05 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 32 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 28 |
| 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 | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8966 |