| National Provider Identifier [NPI]: | 1912158957 |
| Last Name Of The Provider | STEWART |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | CNS |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2990 N. SIOUX |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLAREMORE |
| Zip Code Of The Provider | 740170000 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Certified Clinical Nurse Specialist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 1005 |
| Number Of Medicare Beneficiaries | 434 |
| Total Submitted Charge Amount | 108610 |
| Total Medicare Allowed Amount | 72977.79 |
| Total Medicare Payment Amount | 56902.29 |
| Total Medicare Standardized Payment Amount | 70110.96 |
| 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 | 4 |
| Number Of Medical Services | 1005 |
| Number Of Medicare Beneficiaries With Medical Services | 434 |
| Total Medical Submitted Charge Amount | 108610 |
| Total Medical Medicare Allowed Amount | 72977.79 |
| Total Medical Medicare Payment Amount | 56902.29 |
| Total Medical Medicare Standardized Payment Amount | 70110.96 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 252 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 363 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 45 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 249 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 53 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8304 |