| National Provider Identifier [NPI]: | 1811182769 |
| Last Name Of The Provider | LOVGREN |
| First Name Of The Provider | MARCIE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1450 ELLIS ST |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | BOZEMAN |
| Zip Code Of The Provider | 597158812 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 676 |
| Number Of Medicare Beneficiaries | 133 |
| Total Submitted Charge Amount | 124971.25 |
| Total Medicare Allowed Amount | 23838.95 |
| Total Medicare Payment Amount | 17922.81 |
| Total Medicare Standardized Payment Amount | 19086.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 176 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 528 |
| Total Drug Medicare AllowedAmount | 312.38 |
| Total Drug Medicare PaymentAmount | 222.26 |
| Total Drug Medicare Standardized Payment Amount | 222.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 500 |
| Number Of Medicare Beneficiaries With Medical Services | 133 |
| Total Medical Submitted Charge Amount | 124443.25 |
| Total Medical Medicare Allowed Amount | 23526.57 |
| Total Medical Medicare Payment Amount | 17700.55 |
| Total Medical Medicare Standardized Payment Amount | 18864.58 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 53 |
| 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 | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9851 |