| National Provider Identifier [NPI]: | 1487081105 |
| Last Name Of The Provider | LEWIS-AUSTIN |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 HOSPITAL SOUTH DR |
| Street Address 2 Of The Provider | SUITE 502 |
| City Of The Provider | AUSTELL |
| Zip Code Of The Provider | 301066810 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 1462 |
| Number Of Medicare Beneficiaries | 964 |
| Total Submitted Charge Amount | 203685 |
| Total Medicare Allowed Amount | 86568.99 |
| Total Medicare Payment Amount | 66706.75 |
| Total Medicare Standardized Payment Amount | 78503.47 |
| 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 | 13 |
| Number Of Medical Services | 1462 |
| Number Of Medicare Beneficiaries With Medical Services | 964 |
| Total Medical Submitted Charge Amount | 203685 |
| Total Medical Medicare Allowed Amount | 86568.99 |
| Total Medical Medicare Payment Amount | 66706.75 |
| Total Medical Medicare Standardized Payment Amount | 78503.47 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 226 |
| Number Of Beneficiaries Age 65 to 74 | 348 |
| Number Of Beneficiaries Age 75 to 84 | 299 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 454 |
| Number Of Non Hispanic White Beneficiaries | 640 |
| Number Of Black or African American Beneficiaries | 280 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 716 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 248 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 3.4607 |