| National Provider Identifier [NPI]: | 1861672081 |
| Last Name Of The Provider | SHOUP |
| First Name Of The Provider | SONIA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | APN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14901 E RINCON CREEK RANCH RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 85747 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 537 |
| Number Of Medicare Beneficiaries | 124 |
| Total Submitted Charge Amount | 20550.73 |
| Total Medicare Allowed Amount | 17117.35 |
| Total Medicare Payment Amount | 13658.06 |
| Total Medicare Standardized Payment Amount | 15626.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 569.63 |
| Total Drug Medicare AllowedAmount | 525.78 |
| Total Drug Medicare PaymentAmount | 474.52 |
| Total Drug Medicare Standardized Payment Amount | 474.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 488 |
| Number Of Medicare Beneficiaries With Medical Services | 124 |
| Total Medical Submitted Charge Amount | 19981.1 |
| Total Medical Medicare Allowed Amount | 16591.57 |
| Total Medical Medicare Payment Amount | 13183.54 |
| Total Medical Medicare Standardized Payment Amount | 15151.76 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 73 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | 103 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 15 |
| Percent Of With Ischemic Heart Disease | 10 |
| Percent Of With Osteoporosis | 34 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 10 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.265 |