| National Provider Identifier [NPI]: | 1356615538 |
| Last Name Of The Provider | LARAMORE |
| First Name Of The Provider | SHAYNA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | RN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12639 OLD TESSON RD |
| Street Address 2 Of The Provider | SUITE |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631282786 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 932 |
| Number Of Medicare Beneficiaries | 186 |
| Total Submitted Charge Amount | 383631 |
| Total Medicare Allowed Amount | 39954.63 |
| Total Medicare Payment Amount | 29574.82 |
| Total Medicare Standardized Payment Amount | 35302.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 309 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 4956 |
| Total Drug Medicare AllowedAmount | 1828.72 |
| Total Drug Medicare PaymentAmount | 1406.66 |
| Total Drug Medicare Standardized Payment Amount | 1406.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 623 |
| Number Of Medicare Beneficiaries With Medical Services | 186 |
| Total Medical Submitted Charge Amount | 378675 |
| Total Medical Medicare Allowed Amount | 38125.91 |
| Total Medical Medicare Payment Amount | 28168.16 |
| Total Medical Medicare Standardized Payment Amount | 33895.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 64 |
| 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 | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.185 |