| National Provider Identifier [NPI]: | 1124258124 |
| Last Name Of The Provider | CHENIER |
| First Name Of The Provider | CASILDA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1811 CHARLTON CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOSHEN |
| Zip Code Of The Provider | 465266464 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 374 |
| Number Of Medicare Beneficiaries | 181 |
| Total Submitted Charge Amount | 80651.98 |
| Total Medicare Allowed Amount | 29282.94 |
| Total Medicare Payment Amount | 20636.85 |
| Total Medicare Standardized Payment Amount | 26243.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1008 |
| Total Drug Medicare AllowedAmount | 27.16 |
| Total Drug Medicare PaymentAmount | 23.69 |
| Total Drug Medicare Standardized Payment Amount | 23.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 328 |
| Number Of Medicare Beneficiaries With Medical Services | 181 |
| Total Medical Submitted Charge Amount | 79643.98 |
| Total Medical Medicare Allowed Amount | 29255.78 |
| Total Medical Medicare Payment Amount | 20613.16 |
| Total Medical Medicare Standardized Payment Amount | 26220.06 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 110 |
| Number Of Male Beneficiaries | 71 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9703 |