| National Provider Identifier [NPI]: | 1841533700 |
| Last Name Of The Provider | SHORTER |
| First Name Of The Provider | SARA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1025 MARSH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANKATO |
| Zip Code Of The Provider | 560014752 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 652 |
| Number Of Medicare Beneficiaries | 180 |
| Total Submitted Charge Amount | 106649 |
| Total Medicare Allowed Amount | 32517.59 |
| Total Medicare Payment Amount | 25215.07 |
| Total Medicare Standardized Payment Amount | 30255.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 358 |
| Total Drug Medicare AllowedAmount | 239.13 |
| Total Drug Medicare PaymentAmount | 234.26 |
| Total Drug Medicare Standardized Payment Amount | 234.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 641 |
| Number Of Medicare Beneficiaries With Medical Services | 180 |
| Total Medical Submitted Charge Amount | 106291 |
| Total Medical Medicare Allowed Amount | 32278.46 |
| Total Medical Medicare Payment Amount | 24980.81 |
| Total Medical Medicare Standardized Payment Amount | 30020.82 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 79 |
| 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 | 139 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 54 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7821 |