| National Provider Identifier [NPI]: | 1689676033 |
| Last Name Of The Provider | PIERCY |
| First Name Of The Provider | DAPHNE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APN CFNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 117 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMARGO |
| Zip Code Of The Provider | 619193312 |
| 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 | 19 |
| Number Of Services | 514 |
| Number Of Medicare Beneficiaries | 84 |
| Total Submitted Charge Amount | 34652 |
| Total Medicare Allowed Amount | 24596.54 |
| Total Medicare Payment Amount | 17100.23 |
| Total Medicare Standardized Payment Amount | 21488.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1037 |
| Total Drug Medicare AllowedAmount | 396.17 |
| Total Drug Medicare PaymentAmount | 386.71 |
| Total Drug Medicare Standardized Payment Amount | 386.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 479 |
| Number Of Medicare Beneficiaries With Medical Services | 84 |
| Total Medical Submitted Charge Amount | 33615 |
| Total Medical Medicare Allowed Amount | 24200.37 |
| Total Medical Medicare Payment Amount | 16713.52 |
| Total Medical Medicare Standardized Payment Amount | 21102.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 39 |
| 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 | 13 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8189 |