| National Provider Identifier [NPI]: | 1336476985 |
| Last Name Of The Provider | MAYNARD |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 745 FLETCHER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELGIN |
| Zip Code Of The Provider | 601234747 |
| 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 | 64 |
| Number Of Services | 4494 |
| Number Of Medicare Beneficiaries | 636 |
| Total Submitted Charge Amount | 399523.6 |
| Total Medicare Allowed Amount | 135596.1 |
| Total Medicare Payment Amount | 104518.54 |
| Total Medicare Standardized Payment Amount | 112181.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1534 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 31389.6 |
| Total Drug Medicare AllowedAmount | 23916.99 |
| Total Drug Medicare PaymentAmount | 18953.63 |
| Total Drug Medicare Standardized Payment Amount | 18953.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 2960 |
| Number Of Medicare Beneficiaries With Medical Services | 636 |
| Total Medical Submitted Charge Amount | 368134 |
| Total Medical Medicare Allowed Amount | 111679.11 |
| Total Medical Medicare Payment Amount | 85564.91 |
| Total Medical Medicare Standardized Payment Amount | 93228.34 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 234 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 387 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 609 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 595 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0984 |