| National Provider Identifier [NPI]: | 1659623593 |
| Last Name Of The Provider | CUNNINGHAM |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4081 CASCADE RD SE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495462170 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 284.5 |
| Number Of Medicare Beneficiaries | 171 |
| Total Submitted Charge Amount | 38798.5 |
| Total Medicare Allowed Amount | 13898.28 |
| Total Medicare Payment Amount | 9644.47 |
| Total Medicare Standardized Payment Amount | 11970.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 24.5 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 49.5 |
| Total Drug Medicare AllowedAmount | 23.81 |
| Total Drug Medicare PaymentAmount | 18.68 |
| Total Drug Medicare Standardized Payment Amount | 18.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 260 |
| Number Of Medicare Beneficiaries With Medical Services | 171 |
| Total Medical Submitted Charge Amount | 38749 |
| Total Medical Medicare Allowed Amount | 13874.47 |
| Total Medical Medicare Payment Amount | 9625.79 |
| Total Medical Medicare Standardized Payment Amount | 11952.01 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 148 |
| 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 | 129 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1185 |