| National Provider Identifier [NPI]: | 1669445573 |
| Last Name Of The Provider | SCHUCKERT |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 209 MCNEEL LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH PLATTE |
| Zip Code Of The Provider | 691016054 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1550 |
| Number Of Medicare Beneficiaries | 447 |
| Total Submitted Charge Amount | 227018 |
| Total Medicare Allowed Amount | 131251.45 |
| Total Medicare Payment Amount | 95489.31 |
| Total Medicare Standardized Payment Amount | 103557.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 5010 |
| Total Drug Medicare AllowedAmount | 4006.78 |
| Total Drug Medicare PaymentAmount | 3696.7 |
| Total Drug Medicare Standardized Payment Amount | 3696.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1473 |
| Number Of Medicare Beneficiaries With Medical Services | 447 |
| Total Medical Submitted Charge Amount | 222008 |
| Total Medical Medicare Allowed Amount | 127244.67 |
| Total Medical Medicare Payment Amount | 91792.61 |
| Total Medical Medicare Standardized Payment Amount | 99860.58 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 157 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 189 |
| Number Of Non Hispanic White Beneficiaries | 417 |
| 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 | 338 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 109 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4393 |