| National Provider Identifier [NPI]: | 1184803066 |
| Last Name Of The Provider | HOLDER |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 309 PRAIRIE ST N |
| Street Address 2 Of The Provider | |
| City Of The Provider | UNION SPRINGS |
| Zip Code Of The Provider | 360891418 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 196 |
| Number Of Medicare Beneficiaries | 81 |
| Total Submitted Charge Amount | 9984 |
| Total Medicare Allowed Amount | 5341.5 |
| Total Medicare Payment Amount | 3286.73 |
| Total Medicare Standardized Payment Amount | 5132.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 462 |
| Total Drug Medicare AllowedAmount | 134.63 |
| Total Drug Medicare PaymentAmount | 105.62 |
| Total Drug Medicare Standardized Payment Amount | 105.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 133 |
| Number Of Medicare Beneficiaries With Medical Services | 77 |
| Total Medical Submitted Charge Amount | 9522 |
| Total Medical Medicare Allowed Amount | 5206.87 |
| Total Medical Medicare Payment Amount | 3181.11 |
| Total Medical Medicare Standardized Payment Amount | 5027 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 16 |
| Number Of Black or African American Beneficiaries | 65 |
| 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 | 38 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 17 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.765 |