| National Provider Identifier [NPI]: | 1851308589 |
| Last Name Of The Provider | QUENNEVILLE |
| First Name Of The Provider | BEVERLY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 540 FONTAINE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PENSACOLA |
| Zip Code Of The Provider | 325032019 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 8034 |
| Number Of Medicare Beneficiaries | 1182 |
| Total Submitted Charge Amount | 823039 |
| Total Medicare Allowed Amount | 304141.67 |
| Total Medicare Payment Amount | 229173.63 |
| Total Medicare Standardized Payment Amount | 263190.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 162 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 28524 |
| Total Drug Medicare AllowedAmount | 15741.87 |
| Total Drug Medicare PaymentAmount | 11755.56 |
| Total Drug Medicare Standardized Payment Amount | 11755.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 7872 |
| Number Of Medicare Beneficiaries With Medical Services | 1182 |
| Total Medical Submitted Charge Amount | 794515 |
| Total Medical Medicare Allowed Amount | 288399.8 |
| Total Medical Medicare Payment Amount | 217418.07 |
| Total Medical Medicare Standardized Payment Amount | 251435.21 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 566 |
| Number Of Beneficiaries Age 75 to 84 | 438 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 521 |
| Number Of Male Beneficiaries | 661 |
| Number Of Non Hispanic White Beneficiaries | 1155 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9809 |