| National Provider Identifier [NPI]: | 1972522340 |
| Last Name Of The Provider | STEVENS |
| First Name Of The Provider | JUDY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1830 DESTINY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOWLING GREEN |
| Zip Code Of The Provider | 421041087 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 955 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 127951 |
| Total Medicare Allowed Amount | 53196.18 |
| Total Medicare Payment Amount | 37405.3 |
| Total Medicare Standardized Payment Amount | 49492.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 186 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 4288 |
| Total Drug Medicare AllowedAmount | 276.47 |
| Total Drug Medicare PaymentAmount | 260.8 |
| Total Drug Medicare Standardized Payment Amount | 260.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 769 |
| Number Of Medicare Beneficiaries With Medical Services | 71 |
| Total Medical Submitted Charge Amount | 123663 |
| Total Medical Medicare Allowed Amount | 52919.71 |
| Total Medical Medicare Payment Amount | 37144.5 |
| Total Medical Medicare Standardized Payment Amount | 49231.27 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 49 |
| Number Of Male Beneficiaries | 22 |
| 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 | 44 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 70 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.0829 |