| National Provider Identifier [NPI]: | 1679848493 |
| Last Name Of The Provider | FAULKNER |
| First Name Of The Provider | JOSEPHINE |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3201 INTERSTATE 30 |
| Street Address 2 Of The Provider | SUITE H |
| City Of The Provider | MESQUITE |
| Zip Code Of The Provider | 751502605 |
| 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 | 27 |
| Number Of Services | 1524 |
| Number Of Medicare Beneficiaries | 246 |
| Total Submitted Charge Amount | 228058.01 |
| Total Medicare Allowed Amount | 166495.56 |
| Total Medicare Payment Amount | 127626.94 |
| Total Medicare Standardized Payment Amount | 152451.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 195 |
| Total Drug Medicare AllowedAmount | 152.41 |
| Total Drug Medicare PaymentAmount | 147.14 |
| Total Drug Medicare Standardized Payment Amount | 147.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1512 |
| Number Of Medicare Beneficiaries With Medical Services | 246 |
| Total Medical Submitted Charge Amount | 227863.01 |
| Total Medical Medicare Allowed Amount | 166343.15 |
| Total Medical Medicare Payment Amount | 127479.8 |
| Total Medical Medicare Standardized Payment Amount | 152303.95 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 158 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 171 |
| Number Of Black or African American Beneficiaries | 58 |
| 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 | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 63 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1031 |