| National Provider Identifier [NPI]: | 1639242738 |
| Last Name Of The Provider | SCHIMMELPFENNIGWALDO |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | R.N., M.N., F.N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 LEMAY FERRY RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631253900 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 770 |
| Number Of Medicare Beneficiaries | 172 |
| Total Submitted Charge Amount | 132687 |
| Total Medicare Allowed Amount | 57686.4 |
| Total Medicare Payment Amount | 44275.68 |
| Total Medicare Standardized Payment Amount | 53011.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 450 |
| Total Drug Medicare AllowedAmount | 235.35 |
| Total Drug Medicare PaymentAmount | 229.76 |
| Total Drug Medicare Standardized Payment Amount | 229.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 753 |
| Number Of Medicare Beneficiaries With Medical Services | 172 |
| Total Medical Submitted Charge Amount | 132237 |
| Total Medical Medicare Allowed Amount | 57451.05 |
| Total Medical Medicare Payment Amount | 44045.92 |
| Total Medical Medicare Standardized Payment Amount | 52782.16 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 156 |
| 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 | 105 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 60 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4985 |