| National Provider Identifier [NPI]: | 1376844357 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | SUE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | APRN, FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 HUNTERS LANE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TULLAHOMA |
| Zip Code Of The Provider | 37388 |
| 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 | 53 |
| Number Of Services | 848 |
| Number Of Medicare Beneficiaries | 103 |
| Total Submitted Charge Amount | 43411 |
| Total Medicare Allowed Amount | 21005.7 |
| Total Medicare Payment Amount | 14686.3 |
| Total Medicare Standardized Payment Amount | 18438.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 315 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 4640 |
| Total Drug Medicare AllowedAmount | 2021.02 |
| Total Drug Medicare PaymentAmount | 1576.98 |
| Total Drug Medicare Standardized Payment Amount | 1576.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 533 |
| Number Of Medicare Beneficiaries With Medical Services | 103 |
| Total Medical Submitted Charge Amount | 38771 |
| Total Medical Medicare Allowed Amount | 18984.68 |
| Total Medical Medicare Payment Amount | 13109.32 |
| Total Medical Medicare Standardized Payment Amount | 16861.72 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 37 |
| 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 | 76 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0068 |