| National Provider Identifier [NPI]: | 1669476057 |
| Last Name Of The Provider | HAMILTON |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | RR2 BOX 615A |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCARBRO |
| Zip Code Of The Provider | 25917 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 544 |
| Number Of Medicare Beneficiaries | 254 |
| Total Submitted Charge Amount | 66100 |
| Total Medicare Allowed Amount | 25135.92 |
| Total Medicare Payment Amount | 16946.89 |
| Total Medicare Standardized Payment Amount | 22905.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 150 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 2540 |
| Total Drug Medicare AllowedAmount | 167.54 |
| Total Drug Medicare PaymentAmount | 127.86 |
| Total Drug Medicare Standardized Payment Amount | 127.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 394 |
| Number Of Medicare Beneficiaries With Medical Services | 254 |
| Total Medical Submitted Charge Amount | 63560 |
| Total Medical Medicare Allowed Amount | 24968.38 |
| Total Medical Medicare Payment Amount | 16819.03 |
| Total Medical Medicare Standardized Payment Amount | 22777.8 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 94 |
| 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 | 153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0195 |