| National Provider Identifier [NPI]: | 1053546556 |
| Last Name Of The Provider | ELMORE |
| First Name Of The Provider | WONDA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1201 MICHIGAN AVE |
| Street Address 2 Of The Provider | STE 140 |
| City Of The Provider | LOGANSPORT |
| Zip Code Of The Provider | 469471530 |
| 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 | 27 |
| Number Of Services | 407 |
| Number Of Medicare Beneficiaries | 167 |
| Total Submitted Charge Amount | 36893 |
| Total Medicare Allowed Amount | 20418.04 |
| Total Medicare Payment Amount | 13601.78 |
| Total Medicare Standardized Payment Amount | 17538.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 362 |
| Total Drug Medicare AllowedAmount | 257.15 |
| Total Drug Medicare PaymentAmount | 233.29 |
| Total Drug Medicare Standardized Payment Amount | 233.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 390 |
| Number Of Medicare Beneficiaries With Medical Services | 167 |
| Total Medical Submitted Charge Amount | 36531 |
| Total Medical Medicare Allowed Amount | 20160.89 |
| Total Medical Medicare Payment Amount | 13368.49 |
| Total Medical Medicare Standardized Payment Amount | 17304.76 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 65 |
| 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 | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9658 |