| National Provider Identifier [NPI]: | 1083664643 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2401 W UNIVERSITY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUNCIE |
| Zip Code Of The Provider | 473033428 |
| 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 | 16 |
| Number Of Services | 752 |
| Number Of Medicare Beneficiaries | 663 |
| Total Submitted Charge Amount | 241897 |
| Total Medicare Allowed Amount | 88560.39 |
| Total Medicare Payment Amount | 65298.87 |
| Total Medicare Standardized Payment Amount | 80709.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 752 |
| Number Of Medicare Beneficiaries With Medical Services | 663 |
| Total Medical Submitted Charge Amount | 241897 |
| Total Medical Medicare Allowed Amount | 88560.39 |
| Total Medical Medicare Payment Amount | 65298.87 |
| Total Medical Medicare Standardized Payment Amount | 80709.09 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 257 |
| Number Of Beneficiaries Age 65 to 74 | 173 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 373 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 589 |
| Number Of Black or African American Beneficiaries | 62 |
| 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 | 329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 334 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.977 |