| National Provider Identifier [NPI]: | 1841546512 |
| Last Name Of The Provider | EMBRETSON |
| First Name Of The Provider | STACEY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 911 CARTER ST NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELKADER |
| Zip Code Of The Provider | 520439016 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 759 |
| Number Of Medicare Beneficiaries | 256 |
| Total Submitted Charge Amount | 94582.7 |
| Total Medicare Allowed Amount | 42472.62 |
| Total Medicare Payment Amount | 28423.41 |
| Total Medicare Standardized Payment Amount | 37307.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1050.85 |
| Total Drug Medicare AllowedAmount | 674.39 |
| Total Drug Medicare PaymentAmount | 614.06 |
| Total Drug Medicare Standardized Payment Amount | 614.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 707 |
| Number Of Medicare Beneficiaries With Medical Services | 256 |
| Total Medical Submitted Charge Amount | 93531.85 |
| Total Medical Medicare Allowed Amount | 41798.23 |
| Total Medical Medicare Payment Amount | 27809.35 |
| Total Medical Medicare Standardized Payment Amount | 36693.93 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 95 |
| 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 | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.001 |