| National Provider Identifier [NPI]: | 1881652527 |
| Last Name Of The Provider | HOLMES |
| First Name Of The Provider | MARIANNE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APRN, FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 720 OKATIE HIGHWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIDGELAND |
| Zip Code Of The Provider | 29936 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 1115 |
| Number Of Medicare Beneficiaries | 248 |
| Total Submitted Charge Amount | 82229.78 |
| Total Medicare Allowed Amount | 70954.35 |
| Total Medicare Payment Amount | 52927.02 |
| Total Medicare Standardized Payment Amount | 66256.62 |
| 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 | 6 |
| Number Of Medical Services | 1115 |
| Number Of Medicare Beneficiaries With Medical Services | 248 |
| Total Medical Submitted Charge Amount | 82229.78 |
| Total Medical Medicare Allowed Amount | 70954.35 |
| Total Medical Medicare Payment Amount | 52927.02 |
| Total Medical Medicare Standardized Payment Amount | 66256.62 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 13 |
| Number Of Male Beneficiaries | 235 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| 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 | 221 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 20 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.9731 |