| National Provider Identifier [NPI]: | 1982985057 |
| Last Name Of The Provider | PRISTACH-PATRICK |
| First Name Of The Provider | TINA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7725 N ORACLE RD |
| Street Address 2 Of The Provider | SUITE 131 |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857046986 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 2675 |
| Number Of Medicare Beneficiaries | 258 |
| Total Submitted Charge Amount | 166703.86 |
| Total Medicare Allowed Amount | 57088.95 |
| Total Medicare Payment Amount | 38242.59 |
| Total Medicare Standardized Payment Amount | 45693.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 787 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 9602.69 |
| Total Drug Medicare AllowedAmount | 712.71 |
| Total Drug Medicare PaymentAmount | 490.51 |
| Total Drug Medicare Standardized Payment Amount | 490.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 1888 |
| Number Of Medicare Beneficiaries With Medical Services | 258 |
| Total Medical Submitted Charge Amount | 157101.17 |
| Total Medical Medicare Allowed Amount | 56376.24 |
| Total Medical Medicare Payment Amount | 37752.08 |
| Total Medical Medicare Standardized Payment Amount | 45203.06 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 172 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 231 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9073 |