| National Provider Identifier [NPI]: | 1477821510 |
| Last Name Of The Provider | STACKHOUSE |
| First Name Of The Provider | KATHERINE |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1150 1ST AVE |
| Street Address 2 Of The Provider | SUITE 805 |
| City Of The Provider | KING OF PRUSSIA |
| Zip Code Of The Provider | 194061334 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 2 |
| Number Of Services | 2068 |
| Number Of Medicare Beneficiaries | 1073 |
| Total Submitted Charge Amount | 107561.1 |
| Total Medicare Allowed Amount | 86744.4 |
| Total Medicare Payment Amount | 67627.07 |
| Total Medicare Standardized Payment Amount | 78068 |
| 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 | 2 |
| Number Of Medical Services | 2068 |
| Number Of Medicare Beneficiaries With Medical Services | 1073 |
| Total Medical Submitted Charge Amount | 107561.1 |
| Total Medical Medicare Allowed Amount | 86744.4 |
| Total Medical Medicare Payment Amount | 67627.07 |
| Total Medical Medicare Standardized Payment Amount | 78068 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 303 |
| Number Of Beneficiaries Age Greater 84 | 531 |
| Number Of Female Beneficiaries | 744 |
| Number Of Male Beneficiaries | 329 |
| Number Of Non Hispanic White Beneficiaries | 889 |
| Number Of Black or African American Beneficiaries | 147 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 949 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 57 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 26 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.314 |