| National Provider Identifier [NPI]: | 1295842417 |
| Last Name Of The Provider | STEWARD |
| First Name Of The Provider | KATHLEEN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | APNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2253 W MASON ST |
| Street Address 2 Of The Provider | #200 |
| City Of The Provider | GREEN BAY |
| Zip Code Of The Provider | 54303 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 312 |
| Number Of Medicare Beneficiaries | 106 |
| Total Submitted Charge Amount | 60164.95 |
| Total Medicare Allowed Amount | 17502.06 |
| Total Medicare Payment Amount | 13480.39 |
| Total Medicare Standardized Payment Amount | 16598.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1096.95 |
| Total Drug Medicare AllowedAmount | 669.53 |
| Total Drug Medicare PaymentAmount | 649.84 |
| Total Drug Medicare Standardized Payment Amount | 649.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 289 |
| Number Of Medicare Beneficiaries With Medical Services | 106 |
| Total Medical Submitted Charge Amount | 59068 |
| Total Medical Medicare Allowed Amount | 16832.53 |
| Total Medical Medicare Payment Amount | 12830.55 |
| Total Medical Medicare Standardized Payment Amount | 15948.65 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 21 |
| 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 | 70 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| 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 | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8185 |