| National Provider Identifier [NPI]: | 1134223340 |
| Last Name Of The Provider | SCHMIDT |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 435 LANCASTER DR NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 97301 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 333 |
| Number Of Medicare Beneficiaries | 58 |
| Total Submitted Charge Amount | 36485 |
| Total Medicare Allowed Amount | 18054.19 |
| Total Medicare Payment Amount | 11543.21 |
| Total Medicare Standardized Payment Amount | 14678.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1088 |
| Total Drug Medicare AllowedAmount | 778.66 |
| Total Drug Medicare PaymentAmount | 745.26 |
| Total Drug Medicare Standardized Payment Amount | 745.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 274 |
| Number Of Medicare Beneficiaries With Medical Services | 58 |
| Total Medical Submitted Charge Amount | 35397 |
| Total Medical Medicare Allowed Amount | 17275.53 |
| Total Medical Medicare Payment Amount | 10797.95 |
| Total Medical Medicare Standardized Payment Amount | 13932.75 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 20 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | 39 |
| 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 | 15 |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0425 |