| National Provider Identifier [NPI]: | 1255494902 |
| Last Name Of The Provider | MCCORMICK |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9221 MIDDLEBROOK PIKE |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379314764 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 3040 |
| Number Of Medicare Beneficiaries | 93 |
| Total Submitted Charge Amount | 132088 |
| Total Medicare Allowed Amount | 55552.76 |
| Total Medicare Payment Amount | 39372.39 |
| Total Medicare Standardized Payment Amount | 48580.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1146 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 13372 |
| Total Drug Medicare AllowedAmount | 1398.65 |
| Total Drug Medicare PaymentAmount | 1177.89 |
| Total Drug Medicare Standardized Payment Amount | 1177.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1894 |
| Number Of Medicare Beneficiaries With Medical Services | 93 |
| Total Medical Submitted Charge Amount | 118716 |
| Total Medical Medicare Allowed Amount | 54154.11 |
| Total Medical Medicare Payment Amount | 38194.5 |
| Total Medical Medicare Standardized Payment Amount | 47402.43 |
| Average Age Of Beneficiaries | 54 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 77 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1528 |