| National Provider Identifier [NPI]: | 1124312509 |
| Last Name Of The Provider | ERICKSON |
| First Name Of The Provider | TONIA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 319 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PANORA |
| Zip Code Of The Provider | 502161064 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 2059 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 116531 |
| Total Medicare Allowed Amount | 48670.94 |
| Total Medicare Payment Amount | 34905.62 |
| Total Medicare Standardized Payment Amount | 43977.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 415 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 5629 |
| Total Drug Medicare AllowedAmount | 3977.68 |
| Total Drug Medicare PaymentAmount | 3319.63 |
| Total Drug Medicare Standardized Payment Amount | 3319.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 1644 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 110902 |
| Total Medical Medicare Allowed Amount | 44693.26 |
| Total Medical Medicare Payment Amount | 31585.99 |
| Total Medical Medicare Standardized Payment Amount | 40657.6 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 78 |
| 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 | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9011 |