| National Provider Identifier [NPI]: | 1538350673 |
| Last Name Of The Provider | CREEDON |
| First Name Of The Provider | KATIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 850 HARRISON AVE |
| Street Address 2 Of The Provider | YACC, 3RD FLOOR |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021184001 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 664 |
| Number Of Medicare Beneficiaries | 111 |
| Total Submitted Charge Amount | 193622 |
| Total Medicare Allowed Amount | 68962.78 |
| Total Medicare Payment Amount | 52538.43 |
| Total Medicare Standardized Payment Amount | 58857.62 |
| 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 | 7 |
| Number Of Medical Services | 664 |
| Number Of Medicare Beneficiaries With Medical Services | 111 |
| Total Medical Submitted Charge Amount | 193622 |
| Total Medical Medicare Allowed Amount | 68962.78 |
| Total Medical Medicare Payment Amount | 52538.43 |
| Total Medical Medicare Standardized Payment Amount | 58857.62 |
| Average Age Of Beneficiaries | 83 |
| Number Of Beneficiaries Age Less65 | 0 |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 65 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | 22 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 32 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 64 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 68 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.7355 |