| National Provider Identifier [NPI]: | 1891137337 |
| Last Name Of The Provider | MOUNSEY |
| First Name Of The Provider | MORGAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 504 W CAMP ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEBANON |
| Zip Code Of The Provider | 460521647 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 298 |
| Number Of Medicare Beneficiaries | 173 |
| Total Submitted Charge Amount | 24381 |
| Total Medicare Allowed Amount | 16437.61 |
| Total Medicare Payment Amount | 12618 |
| Total Medicare Standardized Payment Amount | 15691.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 374 |
| Total Drug Medicare AllowedAmount | 178.76 |
| Total Drug Medicare PaymentAmount | 172.32 |
| Total Drug Medicare Standardized Payment Amount | 172.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 282 |
| Number Of Medicare Beneficiaries With Medical Services | 173 |
| Total Medical Submitted Charge Amount | 24007 |
| Total Medical Medicare Allowed Amount | 16258.85 |
| Total Medical Medicare Payment Amount | 12445.68 |
| Total Medical Medicare Standardized Payment Amount | 15519.33 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 61 |
| 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 | 74 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 53 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 24 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1013 |