| National Provider Identifier [NPI]: | 1265663736 |
| Last Name Of The Provider | ECHIVERRI |
| First Name Of The Provider | LEAH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 287 E HUNT HWY |
| Street Address 2 Of The Provider | STE #105 |
| City Of The Provider | SAN TAN VALLEY |
| Zip Code Of The Provider | 851435096 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 4368 |
| Number Of Medicare Beneficiaries | 48 |
| Total Submitted Charge Amount | 376213 |
| Total Medicare Allowed Amount | 138876.73 |
| Total Medicare Payment Amount | 107929.21 |
| Total Medicare Standardized Payment Amount | 116394.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 588 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 12908 |
| Total Drug Medicare AllowedAmount | 5765.59 |
| Total Drug Medicare PaymentAmount | 4509.54 |
| Total Drug Medicare Standardized Payment Amount | 4509.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 3780 |
| Number Of Medicare Beneficiaries With Medical Services | 48 |
| Total Medical Submitted Charge Amount | 363305 |
| Total Medical Medicare Allowed Amount | 133111.14 |
| Total Medical Medicare Payment Amount | 103419.67 |
| Total Medical Medicare Standardized Payment Amount | 111885.27 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 27 |
| Number Of Male Beneficiaries | 21 |
| 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 | 0 |
| 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 | |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.6415 |