| National Provider Identifier [NPI]: | 1881797694 |
| Last Name Of The Provider | ROSS |
| First Name Of The Provider | STACEY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 265 S SCATTERFIELD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANDERSON |
| Zip Code Of The Provider | 460125106 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 363 |
| Number Of Medicare Beneficiaries | 222 |
| Total Submitted Charge Amount | 16814.01 |
| Total Medicare Allowed Amount | 14313.57 |
| Total Medicare Payment Amount | 10236.52 |
| Total Medicare Standardized Payment Amount | 13338.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 99 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 3108.01 |
| Total Drug Medicare AllowedAmount | 2492.72 |
| Total Drug Medicare PaymentAmount | 2442.72 |
| Total Drug Medicare Standardized Payment Amount | 2442.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 264 |
| Number Of Medicare Beneficiaries With Medical Services | 222 |
| Total Medical Submitted Charge Amount | 13706 |
| Total Medical Medicare Allowed Amount | 11820.85 |
| Total Medical Medicare Payment Amount | 7793.8 |
| Total Medical Medicare Standardized Payment Amount | 10895.42 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 84 |
| 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 | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.797 |