| National Provider Identifier [NPI]: | 1912217167 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | SHONNA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | ANP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1650 REPUBLIC PKWY |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MESQUITE |
| Zip Code Of The Provider | 751506916 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 664 |
| Number Of Medicare Beneficiaries | 196 |
| Total Submitted Charge Amount | 57513.37 |
| Total Medicare Allowed Amount | 32125.67 |
| Total Medicare Payment Amount | 23829.53 |
| Total Medicare Standardized Payment Amount | 28007.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1368.5 |
| Total Drug Medicare AllowedAmount | 957.92 |
| Total Drug Medicare PaymentAmount | 918.9 |
| Total Drug Medicare Standardized Payment Amount | 918.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 610 |
| Number Of Medicare Beneficiaries With Medical Services | 196 |
| Total Medical Submitted Charge Amount | 56144.87 |
| Total Medical Medicare Allowed Amount | 31167.75 |
| Total Medical Medicare Payment Amount | 22910.63 |
| Total Medical Medicare Standardized Payment Amount | 27089.06 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | 173 |
| Number Of Black or African American Beneficiaries | 12 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8862 |