National Provider Identifier [NPI]: |
1265771851 |
Last Name Of The Provider |
BRACKIN |
First Name Of The Provider |
TRACI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
FNP-BC |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
907 E LAMAR ALEXANDER PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARYVILLE |
Zip Code Of The Provider |
378045015 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1118 |
Number Of Medicare Beneficiaries |
356 |
Total Submitted Charge Amount |
126918 |
Total Medicare Allowed Amount |
83744.51 |
Total Medicare Payment Amount |
65455.46 |
Total Medicare Standardized Payment Amount |
81331.12 |
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 |
28 |
Number Of Medical Services |
1118 |
Number Of Medicare Beneficiaries With Medical Services |
356 |
Total Medical Submitted Charge Amount |
126918 |
Total Medical Medicare Allowed Amount |
83744.51 |
Total Medical Medicare Payment Amount |
65455.46 |
Total Medical Medicare Standardized Payment Amount |
81331.12 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
113 |
Number Of Beneficiaries Age Greater 84 |
146 |
Number Of Female Beneficiaries |
237 |
Number Of Male Beneficiaries |
119 |
Number Of Non Hispanic White Beneficiaries |
344 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
128 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
63 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9004 |