| National Provider Identifier [NPI]: | 1649530932 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | STACEY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 N COLLEGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENVILLE |
| Zip Code Of The Provider | 360372025 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 608 |
| Number Of Medicare Beneficiaries | 253 |
| Total Submitted Charge Amount | 77633 |
| Total Medicare Allowed Amount | 25245.89 |
| Total Medicare Payment Amount | 17950.66 |
| Total Medicare Standardized Payment Amount | 23642.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1934 |
| Total Drug Medicare AllowedAmount | 127.29 |
| Total Drug Medicare PaymentAmount | 82.77 |
| Total Drug Medicare Standardized Payment Amount | 82.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 505 |
| Number Of Medicare Beneficiaries With Medical Services | 253 |
| Total Medical Submitted Charge Amount | 75699 |
| Total Medical Medicare Allowed Amount | 25118.6 |
| Total Medical Medicare Payment Amount | 17867.89 |
| Total Medical Medicare Standardized Payment Amount | 23559.56 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 167 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 172 |
| 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 | 169 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1827 |