| National Provider Identifier [NPI]: | 1497005623 |
| Last Name Of The Provider | DARIAN |
| First Name Of The Provider | NISA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP-BC, APN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 324 ROOSEVELT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLEN ELLYN |
| Zip Code Of The Provider | 601375647 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 262 |
| Number Of Medicare Beneficiaries | 142 |
| Total Submitted Charge Amount | 9840.19 |
| Total Medicare Allowed Amount | 8373.81 |
| Total Medicare Payment Amount | 6465.12 |
| Total Medicare Standardized Payment Amount | 7898.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 2496.19 |
| Total Drug Medicare AllowedAmount | 1976.8 |
| Total Drug Medicare PaymentAmount | 1937.17 |
| Total Drug Medicare Standardized Payment Amount | 1937.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 181 |
| Number Of Medicare Beneficiaries With Medical Services | 141 |
| Total Medical Submitted Charge Amount | 7344 |
| Total Medical Medicare Allowed Amount | 6397.01 |
| Total Medical Medicare Payment Amount | 4527.95 |
| Total Medical Medicare Standardized Payment Amount | 5961.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 81 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 128 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6532 |