| National Provider Identifier [NPI]: | 1831320118 |
| Last Name Of The Provider | HEWITT |
| First Name Of The Provider | THERESA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2801 W KINNICKINNIC RIVER PKWY STE 245 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532153678 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 405 |
| Number Of Medicare Beneficiaries | 157 |
| Total Submitted Charge Amount | 77900.3 |
| Total Medicare Allowed Amount | 22435.94 |
| Total Medicare Payment Amount | 15696.83 |
| Total Medicare Standardized Payment Amount | 19569.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 790.3 |
| Total Drug Medicare AllowedAmount | 429.92 |
| Total Drug Medicare PaymentAmount | 413.09 |
| Total Drug Medicare Standardized Payment Amount | 413.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 382 |
| Number Of Medicare Beneficiaries With Medical Services | 157 |
| Total Medical Submitted Charge Amount | 77110 |
| Total Medical Medicare Allowed Amount | 22006.02 |
| Total Medical Medicare Payment Amount | 15283.74 |
| Total Medical Medicare Standardized Payment Amount | 19156.32 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 51 |
| 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 | 127 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0904 |