| National Provider Identifier [NPI]: | 1578866596 |
| Last Name Of The Provider | BIRNEY |
| First Name Of The Provider | MISTY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12660 LAMPLIGHTER SQR SHPPNG CTR |
| Street Address 2 Of The Provider | SUITE J |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631282761 |
| 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 | 23 |
| Number Of Services | 4149 |
| Number Of Medicare Beneficiaries | 1283 |
| Total Submitted Charge Amount | 1111205.9 |
| Total Medicare Allowed Amount | 333000.93 |
| Total Medicare Payment Amount | 249277.72 |
| Total Medicare Standardized Payment Amount | 300136.02 |
| 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 | 23 |
| Number Of Medical Services | 4149 |
| Number Of Medicare Beneficiaries With Medical Services | 1283 |
| Total Medical Submitted Charge Amount | 1111205.9 |
| Total Medical Medicare Allowed Amount | 333000.93 |
| Total Medical Medicare Payment Amount | 249277.72 |
| Total Medical Medicare Standardized Payment Amount | 300136.02 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 588 |
| Number Of Beneficiaries Age 65 to 74 | 283 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 642 |
| Number Of Male Beneficiaries | 641 |
| Number Of Non Hispanic White Beneficiaries | 763 |
| Number Of Black or African American Beneficiaries | 490 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| 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 | 184 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1099 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 55 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 55 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.4518 |