| National Provider Identifier [NPI]: | 1003839424 |
| Last Name Of The Provider | STANEK |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2859 STATE STREET |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | MEDFORD |
| Zip Code Of The Provider | 97504 |
| 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 | 30 |
| Number Of Services | 351 |
| Number Of Medicare Beneficiaries | 117 |
| Total Submitted Charge Amount | 56546.44 |
| Total Medicare Allowed Amount | 19020.2 |
| Total Medicare Payment Amount | 13405.78 |
| Total Medicare Standardized Payment Amount | 16550.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 55 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 610.44 |
| Total Drug Medicare AllowedAmount | 373.16 |
| Total Drug Medicare PaymentAmount | 350.73 |
| Total Drug Medicare Standardized Payment Amount | 350.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 296 |
| Number Of Medicare Beneficiaries With Medical Services | 111 |
| Total Medical Submitted Charge Amount | 55936 |
| Total Medical Medicare Allowed Amount | 18647.04 |
| Total Medical Medicare Payment Amount | 13055.05 |
| Total Medical Medicare Standardized Payment Amount | 16199.3 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 38 |
| 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 | 92 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0139 |