| National Provider Identifier [NPI]: | 1346277480 |
| Last Name Of The Provider | HEALY |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | SANDWICH MEDICAL CLINIC |
| Street Address 2 Of The Provider | 10 MECHANIC STR |
| City Of The Provider | SANDWICH |
| Zip Code Of The Provider | 60548 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 193 |
| Number Of Medicare Beneficiaries | 99 |
| Total Submitted Charge Amount | 20107.5 |
| Total Medicare Allowed Amount | 10717.28 |
| Total Medicare Payment Amount | 6070.02 |
| Total Medicare Standardized Payment Amount | 6943.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 749.5 |
| Total Drug Medicare AllowedAmount | 194.71 |
| Total Drug Medicare PaymentAmount | 121.57 |
| Total Drug Medicare Standardized Payment Amount | 121.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 162 |
| Number Of Medicare Beneficiaries With Medical Services | 99 |
| Total Medical Submitted Charge Amount | 19358 |
| Total Medical Medicare Allowed Amount | 10522.57 |
| Total Medical Medicare Payment Amount | 5948.45 |
| Total Medical Medicare Standardized Payment Amount | 6821.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 36 |
| 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 | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8791 |