| National Provider Identifier [NPI]: | 1417196130 |
| Last Name Of The Provider | LOOK |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | APRN, BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9511 HUFFMEISTER RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770952865 |
| 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 | 20 |
| Number Of Services | 121 |
| Number Of Medicare Beneficiaries | 49 |
| Total Submitted Charge Amount | 14491 |
| Total Medicare Allowed Amount | 5457.98 |
| Total Medicare Payment Amount | 4071.25 |
| Total Medicare Standardized Payment Amount | 4634.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1251 |
| Total Drug Medicare AllowedAmount | 471.58 |
| Total Drug Medicare PaymentAmount | 439.65 |
| Total Drug Medicare Standardized Payment Amount | 439.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 86 |
| Number Of Medicare Beneficiaries With Medical Services | 49 |
| Total Medical Submitted Charge Amount | 13240 |
| Total Medical Medicare Allowed Amount | 4986.4 |
| Total Medical Medicare Payment Amount | 3631.6 |
| Total Medical Medicare Standardized Payment Amount | 4194.91 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 30 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | 33 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6009 |