| National Provider Identifier [NPI]: | 1477514271 |
| Last Name Of The Provider | STEWART |
| First Name Of The Provider | FREDA |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | CRNA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4370 W MAIN STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 36305 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | CRNA |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 179 |
| Number Of Medicare Beneficiaries | 177 |
| Total Submitted Charge Amount | 86819.45 |
| Total Medicare Allowed Amount | 22926.77 |
| Total Medicare Payment Amount | 17026.35 |
| Total Medicare Standardized Payment Amount | 19121.68 |
| 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 | 53 |
| Number Of Medical Services | 179 |
| Number Of Medicare Beneficiaries With Medical Services | 177 |
| Total Medical Submitted Charge Amount | 86819.45 |
| Total Medical Medicare Allowed Amount | 22926.77 |
| Total Medical Medicare Payment Amount | 17026.35 |
| Total Medical Medicare Standardized Payment Amount | 19121.68 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5535 |