| National Provider Identifier [NPI]: | 1912998121 |
| Last Name Of The Provider | HEFFNER |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 E EAGER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212025533 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 814 |
| Number Of Medicare Beneficiaries | 300 |
| Total Submitted Charge Amount | 92376 |
| Total Medicare Allowed Amount | 34798.34 |
| Total Medicare Payment Amount | 23771.24 |
| Total Medicare Standardized Payment Amount | 26562.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 197 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 1384 |
| Total Drug Medicare AllowedAmount | 467.26 |
| Total Drug Medicare PaymentAmount | 448.2 |
| Total Drug Medicare Standardized Payment Amount | 448.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 617 |
| Number Of Medicare Beneficiaries With Medical Services | 300 |
| Total Medical Submitted Charge Amount | 90992 |
| Total Medical Medicare Allowed Amount | 34331.08 |
| Total Medical Medicare Payment Amount | 23323.04 |
| Total Medical Medicare Standardized Payment Amount | 26114.59 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 199 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 286 |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2688 |