| National Provider Identifier [NPI]: | 1033191333 |
| Last Name Of The Provider | CHAFEL |
| First Name Of The Provider | THERESA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 SE HOSPITAL AVE |
| Street Address 2 Of The Provider | PATHOLOGY DEPARTMENT |
| City Of The Provider | STUART |
| Zip Code Of The Provider | 349942346 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 4897 |
| Number Of Medicare Beneficiaries | 1537 |
| Total Submitted Charge Amount | 1009653.8 |
| Total Medicare Allowed Amount | 157964.82 |
| Total Medicare Payment Amount | 122964.65 |
| Total Medicare Standardized Payment Amount | 90588.76 |
| 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 | 23 |
| Number Of Medical Services | 4897 |
| Number Of Medicare Beneficiaries With Medical Services | 1537 |
| Total Medical Submitted Charge Amount | 1009653.8 |
| Total Medical Medicare Allowed Amount | 157964.82 |
| Total Medical Medicare Payment Amount | 122964.65 |
| Total Medical Medicare Standardized Payment Amount | 90588.76 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 606 |
| Number Of Beneficiaries Age 75 to 84 | 535 |
| Number Of Beneficiaries Age Greater 84 | 281 |
| Number Of Female Beneficiaries | 831 |
| Number Of Male Beneficiaries | 706 |
| Number Of Non Hispanic White Beneficiaries | 1441 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1405 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 132 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5091 |