| National Provider Identifier [NPI]: | 1427031038 |
| Last Name Of The Provider | SLATE |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6025 WALNUT GROVE ROAD |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38120 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 1599 |
| Number Of Medicare Beneficiaries | 399 |
| Total Submitted Charge Amount | 116890.59 |
| Total Medicare Allowed Amount | 54272.4 |
| Total Medicare Payment Amount | 37481.37 |
| Total Medicare Standardized Payment Amount | 49668.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 2044.59 |
| Total Drug Medicare AllowedAmount | 746.12 |
| Total Drug Medicare PaymentAmount | 677.12 |
| Total Drug Medicare Standardized Payment Amount | 677.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 1531 |
| Number Of Medicare Beneficiaries With Medical Services | 399 |
| Total Medical Submitted Charge Amount | 114846 |
| Total Medical Medicare Allowed Amount | 53526.28 |
| Total Medical Medicare Payment Amount | 36804.25 |
| Total Medical Medicare Standardized Payment Amount | 48991.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 281 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 363 |
| 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 | 364 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.926 |