| National Provider Identifier [NPI]: | 1689766834 |
| Last Name Of The Provider | LOETSCHER |
| First Name Of The Provider | CHERYL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1522 17TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 83501 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 3343 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 167249.6 |
| Total Medicare Allowed Amount | 74054.47 |
| Total Medicare Payment Amount | 56412.25 |
| Total Medicare Standardized Payment Amount | 68460.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 284 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 2759.76 |
| Total Drug Medicare AllowedAmount | 1190.22 |
| Total Drug Medicare PaymentAmount | 1042.77 |
| Total Drug Medicare Standardized Payment Amount | 1042.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 3059 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 164489.84 |
| Total Medical Medicare Allowed Amount | 72864.25 |
| Total Medical Medicare Payment Amount | 55369.48 |
| Total Medical Medicare Standardized Payment Amount | 67417.77 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 74 |
| 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 | 172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9103 |