| National Provider Identifier [NPI]: | 1700215928 |
| Last Name Of The Provider | NOTTMEYER |
| First Name Of The Provider | LORI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | APN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 RICHMOND AVE E |
| Street Address 2 Of The Provider | |
| City Of The Provider | MATTOON |
| Zip Code Of The Provider | 619384652 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1110 |
| Number Of Medicare Beneficiaries | 289 |
| Total Submitted Charge Amount | 83347 |
| Total Medicare Allowed Amount | 53007.53 |
| Total Medicare Payment Amount | 36743.45 |
| Total Medicare Standardized Payment Amount | 45513.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 164 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 5868 |
| Total Drug Medicare AllowedAmount | 2497.21 |
| Total Drug Medicare PaymentAmount | 2099.3 |
| Total Drug Medicare Standardized Payment Amount | 2099.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 946 |
| Number Of Medicare Beneficiaries With Medical Services | 289 |
| Total Medical Submitted Charge Amount | 77479 |
| Total Medical Medicare Allowed Amount | 50510.32 |
| Total Medical Medicare Payment Amount | 34644.15 |
| Total Medical Medicare Standardized Payment Amount | 43414.66 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 119 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3855 |