| National Provider Identifier [NPI]: | 1376796102 |
| Last Name Of The Provider | LAY |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 75 KINGS HIGHWAY CUTOFF |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAIRFIELD |
| Zip Code Of The Provider | 068245340 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 560 |
| Number Of Medicare Beneficiaries | 72 |
| Total Submitted Charge Amount | 35418 |
| Total Medicare Allowed Amount | 14402.58 |
| Total Medicare Payment Amount | 11057.26 |
| Total Medicare Standardized Payment Amount | 11646.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 433 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 9076 |
| Total Drug Medicare AllowedAmount | 4902.1 |
| Total Drug Medicare PaymentAmount | 3747.85 |
| Total Drug Medicare Standardized Payment Amount | 3747.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 127 |
| Number Of Medicare Beneficiaries With Medical Services | 72 |
| Total Medical Submitted Charge Amount | 26342 |
| Total Medical Medicare Allowed Amount | 9500.48 |
| Total Medical Medicare Payment Amount | 7309.41 |
| Total Medical Medicare Standardized Payment Amount | 7898.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | 59 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 55 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0746 |