| National Provider Identifier [NPI]: | 1235486499 |
| Last Name Of The Provider | ELLINGWOOD |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | ANP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1630 LAFAYETTE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | CRAWFORDSVILLE |
| Zip Code Of The Provider | 479331090 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 1399 |
| Number Of Medicare Beneficiaries | 432 |
| Total Submitted Charge Amount | 146707 |
| Total Medicare Allowed Amount | 61768.44 |
| Total Medicare Payment Amount | 43003.19 |
| Total Medicare Standardized Payment Amount | 54436.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1927 |
| Total Drug Medicare AllowedAmount | 1003.48 |
| Total Drug Medicare PaymentAmount | 972.83 |
| Total Drug Medicare Standardized Payment Amount | 972.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1346 |
| Number Of Medicare Beneficiaries With Medical Services | 432 |
| Total Medical Submitted Charge Amount | 144780 |
| Total Medical Medicare Allowed Amount | 60764.96 |
| Total Medical Medicare Payment Amount | 42030.36 |
| Total Medical Medicare Standardized Payment Amount | 53463.65 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 135 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 305 |
| Number Of Male Beneficiaries | 127 |
| 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 | 400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9807 |