| National Provider Identifier [NPI]: | 1558447466 |
| Last Name Of The Provider | ALTER |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | RN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 667 EASTLAND AVE SE |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | WARREN |
| Zip Code Of The Provider | 444844503 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 465 |
| Number Of Medicare Beneficiaries | 130 |
| Total Submitted Charge Amount | 62636 |
| Total Medicare Allowed Amount | 31620.84 |
| Total Medicare Payment Amount | 22188.14 |
| Total Medicare Standardized Payment Amount | 28041.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1071 |
| Total Drug Medicare AllowedAmount | 14.22 |
| Total Drug Medicare PaymentAmount | 9.86 |
| Total Drug Medicare Standardized Payment Amount | 9.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 2 |
| Number Of Medical Services | 431 |
| Number Of Medicare Beneficiaries With Medical Services | 130 |
| Total Medical Submitted Charge Amount | 61565 |
| Total Medical Medicare Allowed Amount | 31606.62 |
| Total Medical Medicare Payment Amount | 22178.28 |
| Total Medical Medicare Standardized Payment Amount | 28032.03 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 75 |
| Number Of Male Beneficiaries | 55 |
| 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 | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4261 |