| National Provider Identifier [NPI]: | 1023303088 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | OTR/L |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 445 N VALLEY FORGE RD |
| Street Address 2 Of The Provider | SUITE 118 |
| City Of The Provider | DEVON |
| Zip Code Of The Provider | 193331239 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Occupational therapist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 3764 |
| Number Of Medicare Beneficiaries | 85 |
| Total Submitted Charge Amount | 199796 |
| Total Medicare Allowed Amount | 112027.99 |
| Total Medicare Payment Amount | 87527.05 |
| Total Medicare Standardized Payment Amount | 53690.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 3764 |
| Number Of Medicare Beneficiaries With Medical Services | 85 |
| Total Medical Submitted Charge Amount | 199796 |
| Total Medical Medicare Allowed Amount | 112027.99 |
| Total Medical Medicare Payment Amount | 87527.05 |
| Total Medical Medicare Standardized Payment Amount | 53690.94 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 15 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 26 |
| 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 | 58 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 52 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6236 |