| National Provider Identifier [NPI]: | 1184931180 |
| Last Name Of The Provider | WANE-SLORY |
| First Name Of The Provider | AGNES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | R.N., M.S.N., F.N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 E BROWN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST STROUDSBURG |
| Zip Code Of The Provider | 183013006 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 113 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 17227.78 |
| Total Medicare Allowed Amount | 4752.61 |
| Total Medicare Payment Amount | 3897.36 |
| Total Medicare Standardized Payment Amount | 4327.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 819.78 |
| Total Drug Medicare AllowedAmount | 748.52 |
| Total Drug Medicare PaymentAmount | 726.94 |
| Total Drug Medicare Standardized Payment Amount | 726.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 88 |
| Number Of Medicare Beneficiaries With Medical Services | 71 |
| Total Medical Submitted Charge Amount | 16408 |
| Total Medical Medicare Allowed Amount | 4004.09 |
| Total Medical Medicare Payment Amount | 3170.42 |
| Total Medical Medicare Standardized Payment Amount | 3600.78 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | 46 |
| 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 | 55 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.8943 |