| National Provider Identifier [NPI]: | 1447214515 |
| Last Name Of The Provider | SCHMIDT |
| First Name Of The Provider | JANE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | RN CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 SOUTH SIBLEY AVE |
| Street Address 2 Of The Provider | AFFILIATED COMMUNITY MEDICAL CENTERS |
| City Of The Provider | LITCHFIELD |
| Zip Code Of The Provider | 55355 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 1194 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 68772.74 |
| Total Medicare Allowed Amount | 22444.46 |
| Total Medicare Payment Amount | 17253.4 |
| Total Medicare Standardized Payment Amount | 20041.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 389 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 2547.09 |
| Total Drug Medicare AllowedAmount | 1696.18 |
| Total Drug Medicare PaymentAmount | 1419.42 |
| Total Drug Medicare Standardized Payment Amount | 1419.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 805 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 66225.65 |
| Total Medical Medicare Allowed Amount | 20748.28 |
| Total Medical Medicare Payment Amount | 15833.98 |
| Total Medical Medicare Standardized Payment Amount | 18622.25 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 75 |
| Number Of Male Beneficiaries | 26 |
| 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 | 58 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| 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 | |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8942 |