| National Provider Identifier [NPI]: | 1508059825 |
| Last Name Of The Provider | CASEBOLT |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 967 BELLEFONTAINE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIMA |
| Zip Code Of The Provider | 458042888 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 235 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 18773.03 |
| Total Medicare Allowed Amount | 10301.04 |
| Total Medicare Payment Amount | 6967.68 |
| Total Medicare Standardized Payment Amount | 8801.47 |
| 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 | 12 |
| Number Of Medical Services | 235 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 18773.03 |
| Total Medical Medicare Allowed Amount | 10301.04 |
| Total Medical Medicare Payment Amount | 6967.68 |
| Total Medical Medicare Standardized Payment Amount | 8801.47 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 189 |
| 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 | 157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9986 |