| National Provider Identifier [NPI]: | 1902849789 |
| Last Name Of The Provider | STECH |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 W UNIVERSITY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHAMPAIGN |
| Zip Code Of The Provider | 618203909 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1200 |
| Number Of Medicare Beneficiaries | 329 |
| Total Submitted Charge Amount | 112414 |
| Total Medicare Allowed Amount | 46709.89 |
| Total Medicare Payment Amount | 33780.91 |
| Total Medicare Standardized Payment Amount | 41829.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 428 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 1978 |
| Total Drug Medicare AllowedAmount | 879.7 |
| Total Drug Medicare PaymentAmount | 751.02 |
| Total Drug Medicare Standardized Payment Amount | 751.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 772 |
| Number Of Medicare Beneficiaries With Medical Services | 329 |
| Total Medical Submitted Charge Amount | 110436 |
| Total Medical Medicare Allowed Amount | 45830.19 |
| Total Medical Medicare Payment Amount | 33029.89 |
| Total Medical Medicare Standardized Payment Amount | 41078.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 199 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 300 |
| 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 | 274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6231 |