| National Provider Identifier [NPI]: | 1124080213 |
| Last Name Of The Provider | AULECIEMS |
| First Name Of The Provider | LINDA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | AMP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8611 W POINT DOUGLAS RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | COTTAGE GROVE |
| Zip Code Of The Provider | 550164005 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 544 |
| Number Of Medicare Beneficiaries | 102 |
| Total Submitted Charge Amount | 56918 |
| Total Medicare Allowed Amount | 21233.81 |
| Total Medicare Payment Amount | 15227.1 |
| Total Medicare Standardized Payment Amount | 18423.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 555 |
| Total Drug Medicare AllowedAmount | 309.42 |
| Total Drug Medicare PaymentAmount | 297.93 |
| Total Drug Medicare Standardized Payment Amount | 297.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 515 |
| Number Of Medicare Beneficiaries With Medical Services | 102 |
| Total Medical Submitted Charge Amount | 56363 |
| Total Medical Medicare Allowed Amount | 20924.39 |
| Total Medical Medicare Payment Amount | 14929.17 |
| Total Medical Medicare Standardized Payment Amount | 18125.84 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 75 |
| Number Of Male Beneficiaries | 27 |
| 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 | 54 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0576 |