| National Provider Identifier [NPI]: | 1225088636 |
| Last Name Of The Provider | SWANSON |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4309 W MEDICAL CENTER DR |
| Street Address 2 Of The Provider | SUITE B202 |
| City Of The Provider | MCHENRY |
| Zip Code Of The Provider | 600508419 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1619 |
| Number Of Medicare Beneficiaries | 532 |
| Total Submitted Charge Amount | 207048.2 |
| Total Medicare Allowed Amount | 90667.05 |
| Total Medicare Payment Amount | 66006.16 |
| Total Medicare Standardized Payment Amount | 80928.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 349 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 9123.2 |
| Total Drug Medicare AllowedAmount | 7116.19 |
| Total Drug Medicare PaymentAmount | 6759.65 |
| Total Drug Medicare Standardized Payment Amount | 6759.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 1270 |
| Number Of Medicare Beneficiaries With Medical Services | 532 |
| Total Medical Submitted Charge Amount | 197925 |
| Total Medical Medicare Allowed Amount | 83550.86 |
| Total Medical Medicare Payment Amount | 59246.51 |
| Total Medical Medicare Standardized Payment Amount | 74169.09 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 267 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 358 |
| Number Of Male Beneficiaries | 174 |
| Number Of Non Hispanic White Beneficiaries | 517 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 482 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9964 |