| National Provider Identifier [NPI]: | 1982835740 |
| Last Name Of The Provider | SCHMITZ |
| First Name Of The Provider | STACY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9000 WAUKEGAN RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MORTON GROVE |
| Zip Code Of The Provider | 600532127 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 172 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 97047 |
| Total Medicare Allowed Amount | 14920.22 |
| Total Medicare Payment Amount | 11064.23 |
| Total Medicare Standardized Payment Amount | 10961.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 2242 |
| Total Drug Medicare AllowedAmount | 1716.45 |
| Total Drug Medicare PaymentAmount | 1345.64 |
| Total Drug Medicare Standardized Payment Amount | 1345.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 150 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 94805 |
| Total Medical Medicare Allowed Amount | 13203.77 |
| Total Medical Medicare Payment Amount | 9718.59 |
| Total Medical Medicare Standardized Payment Amount | 9616.09 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 56 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | 68 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1963 |