| National Provider Identifier [NPI]: | 1194747584 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | RICKY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 835 S THREE NOTCH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANDALUSIA |
| Zip Code Of The Provider | 364205321 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1571 |
| Number Of Medicare Beneficiaries | 387 |
| Total Submitted Charge Amount | 29784 |
| Total Medicare Allowed Amount | 18497.55 |
| Total Medicare Payment Amount | 17871.04 |
| Total Medicare Standardized Payment Amount | 18272.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 173 |
| Number Of Medicare Beneficiaries With Drug Services | 144 |
| Total Drug Submitted ChargeAmount | 2068 |
| Total Drug Medicare AllowedAmount | 1467.83 |
| Total Drug Medicare PaymentAmount | 1380.05 |
| Total Drug Medicare Standardized Payment Amount | 1380.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1398 |
| Number Of Medicare Beneficiaries With Medical Services | 343 |
| Total Medical Submitted Charge Amount | 27716 |
| Total Medical Medicare Allowed Amount | 17029.72 |
| Total Medical Medicare Payment Amount | 16490.99 |
| Total Medical Medicare Standardized Payment Amount | 16892.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 214 |
| Number Of Male Beneficiaries | 173 |
| Number Of Non Hispanic White Beneficiaries | 343 |
| 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 | 304 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0372 |