| National Provider Identifier [NPI]: | 1174550693 |
| Last Name Of The Provider | SUMMERHILL |
| First Name Of The Provider | STEPHANIE |
| 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 | 2113 RUBY RED BLVD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | CLERMONT |
| Zip Code Of The Provider | 347146105 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 2428 |
| Number Of Medicare Beneficiaries | 500 |
| Total Submitted Charge Amount | 473889.05 |
| Total Medicare Allowed Amount | 123806.01 |
| Total Medicare Payment Amount | 88234.5 |
| Total Medicare Standardized Payment Amount | 97035.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 608 |
| Number Of Medicare Beneficiaries With Drug Services | 170 |
| Total Drug Submitted ChargeAmount | 50354.16 |
| Total Drug Medicare AllowedAmount | 24275.21 |
| Total Drug Medicare PaymentAmount | 18548.08 |
| Total Drug Medicare Standardized Payment Amount | 18548.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 1820 |
| Number Of Medicare Beneficiaries With Medical Services | 500 |
| Total Medical Submitted Charge Amount | 423534.89 |
| Total Medical Medicare Allowed Amount | 99530.8 |
| Total Medical Medicare Payment Amount | 69686.42 |
| Total Medical Medicare Standardized Payment Amount | 78487.81 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 224 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 213 |
| Number Of Non Hispanic White Beneficiaries | 466 |
| Number Of Black or African American Beneficiaries | 19 |
| 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 | 469 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1513 |