| National Provider Identifier [NPI]: | 1245260082 |
| Last Name Of The Provider | SCHMIDT |
| First Name Of The Provider | LANA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 N MAPLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EFFINGHAM |
| Zip Code Of The Provider | 624012003 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 10657 |
| Number Of Medicare Beneficiaries | 2110 |
| Total Submitted Charge Amount | 790032 |
| Total Medicare Allowed Amount | 388209.93 |
| Total Medicare Payment Amount | 269259.38 |
| Total Medicare Standardized Payment Amount | 275922.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1691 |
| Number Of Medicare Beneficiaries With Drug Services | 181 |
| Total Drug Submitted ChargeAmount | 14484 |
| Total Drug Medicare AllowedAmount | 10909.57 |
| Total Drug Medicare PaymentAmount | 7896.44 |
| Total Drug Medicare Standardized Payment Amount | 7896.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 8966 |
| Number Of Medicare Beneficiaries With Medical Services | 2110 |
| Total Medical Submitted Charge Amount | 775548 |
| Total Medical Medicare Allowed Amount | 377300.36 |
| Total Medical Medicare Payment Amount | 261362.94 |
| Total Medical Medicare Standardized Payment Amount | 268025.73 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 934 |
| Number Of Beneficiaries Age 75 to 84 | 746 |
| Number Of Beneficiaries Age Greater 84 | 306 |
| Number Of Female Beneficiaries | 1153 |
| Number Of Male Beneficiaries | 957 |
| Number Of Non Hispanic White Beneficiaries | 2091 |
| 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 | 1960 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9508 |