| National Provider Identifier [NPI]: | 1386968295 | 
| Last Name Of The Provider | PALMITER | 
| First Name Of The Provider | SHAWN | 
| Middle Initial Of The Provider | W | 
| Credentials Of The Provider | CRNA | 
| Gender Of The Provider | M | 
| Entity Type Of The Provider | I | 
| Street Address 1 Of The Provider | 110 29TH AVE N STE 202 | 
| Street Address 2 Of The Provider | |
| City Of The Provider | NASHVILLE | 
| Zip Code Of The Provider | 372031448 | 
| State Code Of The Provider | TN | 
| Country Code Of The Provider | US | 
| Provider Type Of The Provider | CRNA | 
| Medicare Participation Indicator | Y | 
| Number Of HCPCS | 25 | 
| Number Of Services | 130 | 
| Number Of Medicare Beneficiaries | 127 | 
| Total Submitted Charge Amount | 136407.55 | 
| Total Medicare Allowed Amount | 12512.25 | 
| Total Medicare Payment Amount | 9686.45 | 
| Total Medicare Standardized Payment Amount | 10257.49 | 
| 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 | 25 | 
| Number Of Medical Services | 130 | 
| Number Of Medicare Beneficiaries With Medical Services | 127 | 
| Total Medical Submitted Charge Amount | 136407.55 | 
| Total Medical Medicare Allowed Amount | 12512.25 | 
| Total Medical Medicare Payment Amount | 9686.45 | 
| Total Medical Medicare Standardized Payment Amount | 10257.49 | 
| Average Age Of Beneficiaries | 70 | 
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 82 | 
| Number Of Beneficiaries Age 75 to 84 | 31 | 
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 71 | 
| Number Of Male Beneficiaries | 56 | 
| Number Of Non Hispanic White Beneficiaries | 115 | 
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 | 
| Number Of American Indian Alaska Native Beneficiaries | 0 | 
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 | 
| Percent Of With Heart Failure | 9 | 
| Percent Of With Chronic Kidney Disease | 13 | 
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 23 | 
| Percent Of With Diabetes | 23 | 
| Percent Of With Hyperlipidemia | 64 | 
| Percent Of With Hypertension | 71 | 
| Percent Of With Ischemic Heart Disease | 28 | 
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 | 
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8333 |