| National Provider Identifier [NPI]: | 1851302780 |
| Last Name Of The Provider | MURRAY |
| First Name Of The Provider | KERI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 CVS DR |
| Street Address 2 Of The Provider | MINUTE CLINIC ATTN CREDENTIALING |
| City Of The Provider | WOONSOCKET |
| Zip Code Of The Provider | 028956146 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 316 |
| Number Of Medicare Beneficiaries | 163 |
| Total Submitted Charge Amount | 10933.68 |
| Total Medicare Allowed Amount | 10407.94 |
| Total Medicare Payment Amount | 9152.75 |
| Total Medicare Standardized Payment Amount | 10027.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 132 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 4145.68 |
| Total Drug Medicare AllowedAmount | 4135.29 |
| Total Drug Medicare PaymentAmount | 4015.6 |
| Total Drug Medicare Standardized Payment Amount | 4015.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 184 |
| Number Of Medicare Beneficiaries With Medical Services | 162 |
| Total Medical Submitted Charge Amount | 6788 |
| Total Medical Medicare Allowed Amount | 6272.65 |
| Total Medical Medicare Payment Amount | 5137.15 |
| Total Medical Medicare Standardized Payment Amount | 6011.86 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 93 |
| Number Of Male Beneficiaries | 70 |
| 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 | 122 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8119 |