| National Provider Identifier [NPI]: | 1134124902 |
| Last Name Of The Provider | WEAVER |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 104 IVY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PULASKI |
| Zip Code Of The Provider | 384784550 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2865 |
| Number Of Medicare Beneficiaries | 269 |
| Total Submitted Charge Amount | 182783.04 |
| Total Medicare Allowed Amount | 106202.08 |
| Total Medicare Payment Amount | 73980.68 |
| Total Medicare Standardized Payment Amount | 94551.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 841 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 13413.04 |
| Total Drug Medicare AllowedAmount | 3736.57 |
| Total Drug Medicare PaymentAmount | 3439.47 |
| Total Drug Medicare Standardized Payment Amount | 3439.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 2024 |
| Number Of Medicare Beneficiaries With Medical Services | 269 |
| Total Medical Submitted Charge Amount | 169370 |
| Total Medical Medicare Allowed Amount | 102465.51 |
| Total Medical Medicare Payment Amount | 70541.21 |
| Total Medical Medicare Standardized Payment Amount | 91111.67 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 221 |
| 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 | 116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1422 |