| National Provider Identifier [NPI]: | 1922307917 |
| Last Name Of The Provider | BLAIR |
| First Name Of The Provider | PAULA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11200 W LINCOLN HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOKENA |
| Zip Code Of The Provider | 604488208 |
| 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 | 15 |
| Number Of Services | 234 |
| Number Of Medicare Beneficiaries | 141 |
| Total Submitted Charge Amount | 10295.24 |
| Total Medicare Allowed Amount | 9668.14 |
| Total Medicare Payment Amount | 7120.05 |
| Total Medicare Standardized Payment Amount | 8139.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 2275.24 |
| Total Drug Medicare AllowedAmount | 2264.57 |
| Total Drug Medicare PaymentAmount | 2205.88 |
| Total Drug Medicare Standardized Payment Amount | 2205.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 157 |
| Number Of Medicare Beneficiaries With Medical Services | 141 |
| Total Medical Submitted Charge Amount | 8020 |
| Total Medical Medicare Allowed Amount | 7403.57 |
| Total Medical Medicare Payment Amount | 4914.17 |
| Total Medical Medicare Standardized Payment Amount | 5933.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 55 |
| 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 | |
| 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 | 14 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8334 |