| National Provider Identifier [NPI]: | 1770830473 |
| Last Name Of The Provider | CHAVEZ |
| First Name Of The Provider | SARAH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MSN, C, FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 195 SOUTH HASTER BLVD SUITE B-1 |
| Street Address 2 Of The Provider | BASTROP MEDICA CLINIC, PA |
| City Of The Provider | BASTROP |
| Zip Code Of The Provider | 786024081 |
| 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 | 75 |
| Number Of Services | 3453 |
| Number Of Medicare Beneficiaries | 333 |
| Total Submitted Charge Amount | 174673 |
| Total Medicare Allowed Amount | 57411.45 |
| Total Medicare Payment Amount | 40335.88 |
| Total Medicare Standardized Payment Amount | 49961.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 2332 |
| Number Of Medicare Beneficiaries With Drug Services | 152 |
| Total Drug Submitted ChargeAmount | 20608 |
| Total Drug Medicare AllowedAmount | 846.88 |
| Total Drug Medicare PaymentAmount | 649.07 |
| Total Drug Medicare Standardized Payment Amount | 649.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 1121 |
| Number Of Medicare Beneficiaries With Medical Services | 333 |
| Total Medical Submitted Charge Amount | 154065 |
| Total Medical Medicare Allowed Amount | 56564.57 |
| Total Medical Medicare Payment Amount | 39686.81 |
| Total Medical Medicare Standardized Payment Amount | 49312.69 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 262 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9571 |