| National Provider Identifier [NPI]: | 1396926945 |
| Last Name Of The Provider | REYNOLDS |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2424 50TH ST |
| Street Address 2 Of The Provider | STE 202 |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794122549 |
| 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 | 32 |
| Number Of Services | 339 |
| Number Of Medicare Beneficiaries | 55 |
| Total Submitted Charge Amount | 26574 |
| Total Medicare Allowed Amount | 10810.92 |
| Total Medicare Payment Amount | 7712.46 |
| Total Medicare Standardized Payment Amount | 9483.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1356 |
| Total Drug Medicare AllowedAmount | 146.6 |
| Total Drug Medicare PaymentAmount | 120.42 |
| Total Drug Medicare Standardized Payment Amount | 120.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 266 |
| Number Of Medicare Beneficiaries With Medical Services | 55 |
| Total Medical Submitted Charge Amount | 25218 |
| Total Medical Medicare Allowed Amount | 10664.32 |
| Total Medical Medicare Payment Amount | 7592.04 |
| Total Medical Medicare Standardized Payment Amount | 9363.45 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 17 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 41 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 33 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.0419 |