| National Provider Identifier [NPI]: | 1326365693 |
| Last Name Of The Provider | THRON |
| First Name Of The Provider | SHELLEY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | RN, MSN, CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 153 CESAR CHAVEZ ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551072226 |
| 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 | 14 |
| Number Of Services | 87 |
| Number Of Medicare Beneficiaries | 32 |
| Total Submitted Charge Amount | 2691.05 |
| Total Medicare Allowed Amount | 1246.82 |
| Total Medicare Payment Amount | 977.69 |
| Total Medicare Standardized Payment Amount | 1049.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 646.08 |
| Total Drug Medicare AllowedAmount | 502.16 |
| Total Drug Medicare PaymentAmount | 404.33 |
| Total Drug Medicare Standardized Payment Amount | 404.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 65 |
| Number Of Medicare Beneficiaries With Medical Services | 32 |
| Total Medical Submitted Charge Amount | 2044.97 |
| Total Medical Medicare Allowed Amount | 744.66 |
| Total Medical Medicare Payment Amount | 573.36 |
| Total Medical Medicare Standardized Payment Amount | 645.37 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | 0 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 0 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | 38 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1 |