| National Provider Identifier [NPI]: | 1306274014 |
| Last Name Of The Provider | CORNWELL |
| First Name Of The Provider | ANNA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | NP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2409 MITCHELL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEDFORD |
| Zip Code Of The Provider | 474214731 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 521 |
| Number Of Medicare Beneficiaries | 279 |
| Total Submitted Charge Amount | 17838.02 |
| Total Medicare Allowed Amount | 16374.82 |
| Total Medicare Payment Amount | 13509.88 |
| Total Medicare Standardized Payment Amount | 15620.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 210 |
| Number Of Medicare Beneficiaries With Drug Services | 197 |
| Total Drug Submitted ChargeAmount | 5320.02 |
| Total Drug Medicare AllowedAmount | 5320.02 |
| Total Drug Medicare PaymentAmount | 5180.81 |
| Total Drug Medicare Standardized Payment Amount | 5180.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 311 |
| Number Of Medicare Beneficiaries With Medical Services | 277 |
| Total Medical Submitted Charge Amount | 12518 |
| Total Medical Medicare Allowed Amount | 11054.8 |
| Total Medical Medicare Payment Amount | 8329.07 |
| Total Medical Medicare Standardized Payment Amount | 10439.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 172 |
| Number Of Male Beneficiaries | 107 |
| 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 | 257 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7146 |