| National Provider Identifier [NPI]: | 1275627523 |
| Last Name Of The Provider | KINNAMAN |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 E BOYD AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | GREENFIELD |
| Zip Code Of The Provider | 461402816 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 1946 |
| Number Of Medicare Beneficiaries | 365 |
| Total Submitted Charge Amount | 137111.5 |
| Total Medicare Allowed Amount | 85812.73 |
| Total Medicare Payment Amount | 59457.71 |
| Total Medicare Standardized Payment Amount | 63137.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 273 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 8383.5 |
| Total Drug Medicare AllowedAmount | 6160.74 |
| Total Drug Medicare PaymentAmount | 5853.15 |
| Total Drug Medicare Standardized Payment Amount | 5853.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 1673 |
| Number Of Medicare Beneficiaries With Medical Services | 363 |
| Total Medical Submitted Charge Amount | 128728 |
| Total Medical Medicare Allowed Amount | 79651.99 |
| Total Medical Medicare Payment Amount | 53604.56 |
| Total Medical Medicare Standardized Payment Amount | 57284.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 122 |
| Number Of Non Hispanic White Beneficiaries | 348 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.039 |