| National Provider Identifier [NPI]: | 1629058128 |
| Last Name Of The Provider | STEPHENS |
| First Name Of The Provider | TANYA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP-BC, NP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1539 CLAVEY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HIGHLAND PARK |
| Zip Code Of The Provider | 600354414 |
| 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 | 18 |
| Number Of Services | 438 |
| Number Of Medicare Beneficiaries | 236 |
| Total Submitted Charge Amount | 15557.24 |
| Total Medicare Allowed Amount | 14752.02 |
| Total Medicare Payment Amount | 12258.18 |
| Total Medicare Standardized Payment Amount | 13541.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 176 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 5313.24 |
| Total Drug Medicare AllowedAmount | 5273.35 |
| Total Drug Medicare PaymentAmount | 5080.45 |
| Total Drug Medicare Standardized Payment Amount | 5080.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 262 |
| Number Of Medicare Beneficiaries With Medical Services | 234 |
| Total Medical Submitted Charge Amount | 10244 |
| Total Medical Medicare Allowed Amount | 9478.67 |
| Total Medical Medicare Payment Amount | 7177.73 |
| Total Medical Medicare Standardized Payment Amount | 8461.27 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 96 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.766 |