| National Provider Identifier [NPI]: | 1326367954 |
| Last Name Of The Provider | CHEN |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 S PARK LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALTUS |
| Zip Code Of The Provider | 735215755 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1300 |
| Number Of Medicare Beneficiaries | 317 |
| Total Submitted Charge Amount | 78315.21 |
| Total Medicare Allowed Amount | 42947.33 |
| Total Medicare Payment Amount | 30007.31 |
| Total Medicare Standardized Payment Amount | 39414.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 514 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 9396.85 |
| Total Drug Medicare AllowedAmount | 2246.29 |
| Total Drug Medicare PaymentAmount | 1921.32 |
| Total Drug Medicare Standardized Payment Amount | 1921.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 786 |
| Number Of Medicare Beneficiaries With Medical Services | 317 |
| Total Medical Submitted Charge Amount | 68918.36 |
| Total Medical Medicare Allowed Amount | 40701.04 |
| Total Medical Medicare Payment Amount | 28085.99 |
| Total Medical Medicare Standardized Payment Amount | 37493.57 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 221 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 251 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2413 |