| National Provider Identifier [NPI]: | 1487621793 |
| Last Name Of The Provider | DEMARCO |
| First Name Of The Provider | TONI |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | CRNA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 N NAPPANEE ST |
| Street Address 2 Of The Provider | STE 11B |
| City Of The Provider | ELKHART |
| Zip Code Of The Provider | 465141503 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | CRNA |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 404 |
| Number Of Medicare Beneficiaries | 329 |
| Total Submitted Charge Amount | 216380 |
| Total Medicare Allowed Amount | 27399.55 |
| Total Medicare Payment Amount | 21481.17 |
| Total Medicare Standardized Payment Amount | 21524.4 |
| 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 | 16 |
| Number Of Medical Services | 404 |
| Number Of Medicare Beneficiaries With Medical Services | 329 |
| Total Medical Submitted Charge Amount | 216380 |
| Total Medical Medicare Allowed Amount | 27399.55 |
| Total Medical Medicare Payment Amount | 21481.17 |
| Total Medical Medicare Standardized Payment Amount | 21524.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 109 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | 294 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 294 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9114 |