| National Provider Identifier [NPI]: | 1225477722 |
| Last Name Of The Provider | REESE |
| First Name Of The Provider | SARA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 THEDA CLARK MEDICAL PLZ |
| Street Address 2 Of The Provider | STE 240 |
| City Of The Provider | NEENAH |
| Zip Code Of The Provider | 549562721 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 1417 |
| Number Of Medicare Beneficiaries | 261 |
| Total Submitted Charge Amount | 151776.05 |
| Total Medicare Allowed Amount | 47163.36 |
| Total Medicare Payment Amount | 34715.3 |
| Total Medicare Standardized Payment Amount | 41283.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1037 |
| Total Drug Medicare AllowedAmount | 813.38 |
| Total Drug Medicare PaymentAmount | 766.23 |
| Total Drug Medicare Standardized Payment Amount | 766.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 1386 |
| Number Of Medicare Beneficiaries With Medical Services | 261 |
| Total Medical Submitted Charge Amount | 150739.05 |
| Total Medical Medicare Allowed Amount | 46349.98 |
| Total Medical Medicare Payment Amount | 33949.07 |
| Total Medical Medicare Standardized Payment Amount | 40516.83 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 77 |
| 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 | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2483 |