| National Provider Identifier [NPI]: | 1508890823 |
| Last Name Of The Provider | WIJEWEERA |
| First Name Of The Provider | HELEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | ANP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4921 PARKVIEW PL |
| Street Address 2 Of The Provider | 5TH FLOOR SUITE C |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631101032 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 795 |
| Number Of Medicare Beneficiaries | 297 |
| Total Submitted Charge Amount | 267453 |
| Total Medicare Allowed Amount | 58315.59 |
| Total Medicare Payment Amount | 45211.95 |
| Total Medicare Standardized Payment Amount | 52876.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 83 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 18583 |
| Total Drug Medicare AllowedAmount | 9692.91 |
| Total Drug Medicare PaymentAmount | 9056.63 |
| Total Drug Medicare Standardized Payment Amount | 9056.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 712 |
| Number Of Medicare Beneficiaries With Medical Services | 296 |
| Total Medical Submitted Charge Amount | 248870 |
| Total Medical Medicare Allowed Amount | 48622.68 |
| Total Medical Medicare Payment Amount | 36155.32 |
| Total Medical Medicare Standardized Payment Amount | 43820.13 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 200 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 202 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 4.236 |