| National Provider Identifier [NPI]: | 1447407895 |
| Last Name Of The Provider | RIVES |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1040 RIVER OAKS DR |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | FLOWOOD |
| Zip Code Of The Provider | 392329530 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1097 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 85951 |
| Total Medicare Allowed Amount | 52711.97 |
| Total Medicare Payment Amount | 38472.21 |
| Total Medicare Standardized Payment Amount | 51228.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 86 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 2247 |
| Total Drug Medicare AllowedAmount | 868.74 |
| Total Drug Medicare PaymentAmount | 844.54 |
| Total Drug Medicare Standardized Payment Amount | 844.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1011 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 83704 |
| Total Medical Medicare Allowed Amount | 51843.23 |
| Total Medical Medicare Payment Amount | 37627.67 |
| Total Medical Medicare Standardized Payment Amount | 50383.64 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 187 |
| 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 | 263 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5461 |