| National Provider Identifier [NPI]: | 1477830909 |
| Last Name Of The Provider | BROADNAX |
| First Name Of The Provider | LINDSEY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 655 7TH ST BLDG 700 |
| Street Address 2 Of The Provider | 78 MDG/SGOHF |
| City Of The Provider | WARNER ROBINS |
| Zip Code Of The Provider | 310982227 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 162 |
| Number Of Medicare Beneficiaries | 132 |
| Total Submitted Charge Amount | 49101.27 |
| Total Medicare Allowed Amount | 15407.97 |
| Total Medicare Payment Amount | 12036.98 |
| Total Medicare Standardized Payment Amount | 14461.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 162 |
| Number Of Medicare Beneficiaries With Medical Services | 132 |
| Total Medical Submitted Charge Amount | 49101.27 |
| Total Medical Medicare Allowed Amount | 15407.97 |
| Total Medical Medicare Payment Amount | 12036.98 |
| Total Medical Medicare Standardized Payment Amount | 14461.21 |
| Average Age Of Beneficiaries | 50 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 61 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 65 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 75 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5328 |