| National Provider Identifier [NPI]: | 1235174186 |
| Last Name Of The Provider | NOELL |
| First Name Of The Provider | TRACY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 851 MARSHALL PHELPS ROAD |
| Street Address 2 Of The Provider | HEALTHONE WINDSOR FAMILY MEDICINE |
| City Of The Provider | WINDSOR |
| Zip Code Of The Provider | 06095 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 451 |
| Number Of Medicare Beneficiaries | 143 |
| Total Submitted Charge Amount | 53037 |
| Total Medicare Allowed Amount | 28553.28 |
| Total Medicare Payment Amount | 20277.88 |
| Total Medicare Standardized Payment Amount | 22300.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 989 |
| Total Drug Medicare AllowedAmount | 784.79 |
| Total Drug Medicare PaymentAmount | 768.67 |
| Total Drug Medicare Standardized Payment Amount | 768.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 424 |
| Number Of Medicare Beneficiaries With Medical Services | 143 |
| Total Medical Submitted Charge Amount | 52048 |
| Total Medical Medicare Allowed Amount | 27768.49 |
| Total Medical Medicare Payment Amount | 19509.21 |
| Total Medical Medicare Standardized Payment Amount | 21532.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 116 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | 117 |
| 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 | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7898 |