| National Provider Identifier [NPI]: | 1275572851 |
| Last Name Of The Provider | STOLL |
| First Name Of The Provider | PEGGY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12412 JUDSON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIVE OAK |
| Zip Code Of The Provider | 782333255 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1327 |
| Number Of Medicare Beneficiaries | 472 |
| Total Submitted Charge Amount | 163824 |
| Total Medicare Allowed Amount | 36253.66 |
| Total Medicare Payment Amount | 28240.72 |
| Total Medicare Standardized Payment Amount | 24045.08 |
| 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 | 19 |
| Number Of Medical Services | 1327 |
| Number Of Medicare Beneficiaries With Medical Services | 472 |
| Total Medical Submitted Charge Amount | 163824 |
| Total Medical Medicare Allowed Amount | 36253.66 |
| Total Medical Medicare Payment Amount | 28240.72 |
| Total Medical Medicare Standardized Payment Amount | 24045.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 254 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 310 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 104 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 65 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 3.1262 |