| National Provider Identifier [NPI]: | 1902118169 |
| Last Name Of The Provider | CUTHBERT |
| First Name Of The Provider | ANN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MSN FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 W LINCOLN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOSHEN |
| Zip Code Of The Provider | 465262413 |
| 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 | 46 |
| Number Of Services | 781 |
| Number Of Medicare Beneficiaries | 78 |
| Total Submitted Charge Amount | 42844.92 |
| Total Medicare Allowed Amount | 22326.53 |
| Total Medicare Payment Amount | 15996.73 |
| Total Medicare Standardized Payment Amount | 19348.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 230 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 5816.45 |
| Total Drug Medicare AllowedAmount | 3850.12 |
| Total Drug Medicare PaymentAmount | 3267.37 |
| Total Drug Medicare Standardized Payment Amount | 3267.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 551 |
| Number Of Medicare Beneficiaries With Medical Services | 78 |
| Total Medical Submitted Charge Amount | 37028.47 |
| Total Medical Medicare Allowed Amount | 18476.41 |
| Total Medical Medicare Payment Amount | 12729.36 |
| Total Medical Medicare Standardized Payment Amount | 16080.94 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 48 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 54 |
| 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 | 27 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9541 |