| National Provider Identifier [NPI]: | 1528220670 |
| Last Name Of The Provider | SETCHELL |
| First Name Of The Provider | STACIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | O.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 E MARKET ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MORRISON |
| Zip Code Of The Provider | 612702854 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 403 |
| Number Of Medicare Beneficiaries | 223 |
| Total Submitted Charge Amount | 68550 |
| Total Medicare Allowed Amount | 38938.43 |
| Total Medicare Payment Amount | 27671.23 |
| Total Medicare Standardized Payment Amount | 29790.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 403 |
| Number Of Medicare Beneficiaries With Medical Services | 223 |
| Total Medical Submitted Charge Amount | 68550 |
| Total Medical Medicare Allowed Amount | 38938.43 |
| Total Medical Medicare Payment Amount | 27671.23 |
| Total Medical Medicare Standardized Payment Amount | 29790.63 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | 169 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 92 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4051 |