| National Provider Identifier [NPI]: | 1972850063 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | KATHARINE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APRN, NP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1269 WELLBROOK CIR NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CONYERS |
| Zip Code Of The Provider | 300123873 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 82 |
| Number Of Medicare Beneficiaries | 48 |
| Total Submitted Charge Amount | 3736.81 |
| Total Medicare Allowed Amount | 3035.59 |
| Total Medicare Payment Amount | 2053.96 |
| Total Medicare Standardized Payment Amount | 2576.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 732.81 |
| Total Drug Medicare AllowedAmount | 621.2 |
| Total Drug Medicare PaymentAmount | 608.73 |
| Total Drug Medicare Standardized Payment Amount | 608.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 62 |
| Number Of Medicare Beneficiaries With Medical Services | 48 |
| Total Medical Submitted Charge Amount | 3004 |
| Total Medical Medicare Allowed Amount | 2414.39 |
| Total Medical Medicare Payment Amount | 1445.23 |
| Total Medical Medicare Standardized Payment Amount | 1968.15 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 17 |
| 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 | 28 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.9391 |