| National Provider Identifier [NPI]: | 1679914832 |
| Last Name Of The Provider | BUTTS |
| First Name Of The Provider | KIMBERLEY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | A.P.R.N. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 935 STATE ROUTE 28 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILFORD |
| Zip Code Of The Provider | 451501957 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 235 |
| Number Of Medicare Beneficiaries | 126 |
| Total Submitted Charge Amount | 23377 |
| Total Medicare Allowed Amount | 12931.48 |
| Total Medicare Payment Amount | 9573.41 |
| Total Medicare Standardized Payment Amount | 11903.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 271 |
| Total Drug Medicare AllowedAmount | 91.02 |
| Total Drug Medicare PaymentAmount | 83.13 |
| Total Drug Medicare Standardized Payment Amount | 83.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 206 |
| Number Of Medicare Beneficiaries With Medical Services | 126 |
| Total Medical Submitted Charge Amount | 23106 |
| Total Medical Medicare Allowed Amount | 12840.46 |
| Total Medical Medicare Payment Amount | 9490.28 |
| Total Medical Medicare Standardized Payment Amount | 11820.47 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 82 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | 106 |
| 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 | 93 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9616 |