| National Provider Identifier [NPI]: | 1881028553 |
| Last Name Of The Provider | NALE |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1919 STATE ST STE 104 |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW ALBANY |
| Zip Code Of The Provider | 471506802 |
| 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 | 39 |
| Number Of Services | 1173 |
| Number Of Medicare Beneficiaries | 145 |
| Total Submitted Charge Amount | 312226 |
| Total Medicare Allowed Amount | 164251.45 |
| Total Medicare Payment Amount | 128466.55 |
| Total Medicare Standardized Payment Amount | 156606.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 700 |
| Total Drug Medicare AllowedAmount | 467.18 |
| Total Drug Medicare PaymentAmount | 457.8 |
| Total Drug Medicare Standardized Payment Amount | 457.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1159 |
| Number Of Medicare Beneficiaries With Medical Services | 145 |
| Total Medical Submitted Charge Amount | 311526 |
| Total Medical Medicare Allowed Amount | 163784.27 |
| Total Medical Medicare Payment Amount | 128008.75 |
| Total Medical Medicare Standardized Payment Amount | 156148.48 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 32 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 81 |
| Number Of Male Beneficiaries | 64 |
| 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 | 71 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 67 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3454 |