| National Provider Identifier [NPI]: | 1366460222 |
| Last Name Of The Provider | LUIPPOLD |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | RNCS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 759 CHESNUT STREET |
| Street Address 2 Of The Provider | S2676 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 01199 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Certified Clinical Nurse Specialist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 203 |
| Number Of Medicare Beneficiaries | 109 |
| Total Submitted Charge Amount | 49272 |
| Total Medicare Allowed Amount | 19937.18 |
| Total Medicare Payment Amount | 15453.13 |
| Total Medicare Standardized Payment Amount | 17978.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 203 |
| Number Of Medicare Beneficiaries With Medical Services | 109 |
| Total Medical Submitted Charge Amount | 49272 |
| Total Medical Medicare Allowed Amount | 19937.18 |
| Total Medical Medicare Payment Amount | 15453.13 |
| Total Medical Medicare Standardized Payment Amount | 17978.11 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 80 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 27 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 36 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0549 |