| National Provider Identifier [NPI]: | 1881842037 |
| Last Name Of The Provider | DORA |
| First Name Of The Provider | AMANDA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4515 MARSHA SHARP FWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794072520 |
| 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 | 14 |
| Number Of Services | 252 |
| Number Of Medicare Beneficiaries | 61 |
| Total Submitted Charge Amount | 30745.68 |
| Total Medicare Allowed Amount | 12141.18 |
| Total Medicare Payment Amount | 9223.68 |
| Total Medicare Standardized Payment Amount | 10323.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 134 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 19843.28 |
| Total Drug Medicare AllowedAmount | 7056.87 |
| Total Drug Medicare PaymentAmount | 5143.68 |
| Total Drug Medicare Standardized Payment Amount | 5143.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 118 |
| Number Of Medicare Beneficiaries With Medical Services | 61 |
| Total Medical Submitted Charge Amount | 10902.4 |
| Total Medical Medicare Allowed Amount | 5084.31 |
| Total Medical Medicare Payment Amount | 4080 |
| Total Medical Medicare Standardized Payment Amount | 5179.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| 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 | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.903 |