| National Provider Identifier [NPI]: | 1245246099 |
| Last Name Of The Provider | STANFORD |
| First Name Of The Provider | TERESA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1105 EARL FRYE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | AMORY |
| Zip Code Of The Provider | 388215500 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 3291 |
| Number Of Medicare Beneficiaries | 651 |
| Total Submitted Charge Amount | 349288.24 |
| Total Medicare Allowed Amount | 117819.37 |
| Total Medicare Payment Amount | 89352.32 |
| Total Medicare Standardized Payment Amount | 110385.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 929 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 18976 |
| Total Drug Medicare AllowedAmount | 5853.13 |
| Total Drug Medicare PaymentAmount | 4776.22 |
| Total Drug Medicare Standardized Payment Amount | 4776.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 2362 |
| Number Of Medicare Beneficiaries With Medical Services | 651 |
| Total Medical Submitted Charge Amount | 330312.24 |
| Total Medical Medicare Allowed Amount | 111966.24 |
| Total Medical Medicare Payment Amount | 84576.1 |
| Total Medical Medicare Standardized Payment Amount | 105609.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 427 |
| Number Of Male Beneficiaries | 224 |
| Number Of Non Hispanic White Beneficiaries | 528 |
| 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 | 417 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 234 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.3455 |