| National Provider Identifier [NPI]: | 1942378849 |
| Last Name Of The Provider | LAVEY |
| First Name Of The Provider | TRACEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 732 HARRISON AVE |
| Street Address 2 Of The Provider | PRESTON, 3RD FLOOR |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021182309 |
| 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 | 15 |
| Number Of Services | 336 |
| Number Of Medicare Beneficiaries | 246 |
| Total Submitted Charge Amount | 51364 |
| Total Medicare Allowed Amount | 15758.93 |
| Total Medicare Payment Amount | 11015.5 |
| Total Medicare Standardized Payment Amount | 12619.31 |
| 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 | 15 |
| Number Of Medical Services | 336 |
| Number Of Medicare Beneficiaries With Medical Services | 246 |
| Total Medical Submitted Charge Amount | 51364 |
| Total Medical Medicare Allowed Amount | 15758.93 |
| Total Medical Medicare Payment Amount | 11015.5 |
| Total Medical Medicare Standardized Payment Amount | 12619.31 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 91 |
| Number Of Male Beneficiaries | 155 |
| Number Of Non Hispanic White Beneficiaries | 142 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 48 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 64 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9934 |