| National Provider Identifier [NPI]: | 1215116983 |
| Last Name Of The Provider | WACH |
| First Name Of The Provider | SHERRY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MS CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1492 E BROAD ST |
| Street Address 2 Of The Provider | 12TH FLOOR TOWER, SUITE 1203 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432051546 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 213 |
| Number Of Medicare Beneficiaries | 36 |
| Total Submitted Charge Amount | 18387.6 |
| Total Medicare Allowed Amount | 8174.28 |
| Total Medicare Payment Amount | 6374.58 |
| Total Medicare Standardized Payment Amount | 7469.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3037.6 |
| Total Drug Medicare AllowedAmount | 1078.21 |
| Total Drug Medicare PaymentAmount | 1056.68 |
| Total Drug Medicare Standardized Payment Amount | 1056.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 191 |
| Number Of Medicare Beneficiaries With Medical Services | 36 |
| Total Medical Submitted Charge Amount | 15350 |
| Total Medical Medicare Allowed Amount | 7096.07 |
| Total Medical Medicare Payment Amount | 5317.9 |
| Total Medical Medicare Standardized Payment Amount | 6413.24 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5819 |