| National Provider Identifier [NPI]: | 1538259791 |
| Last Name Of The Provider | CARNEY |
| First Name Of The Provider | TRACI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14002 E 21ST ST |
| Street Address 2 Of The Provider | SUITE 1130 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741341412 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 261 |
| Number Of Medicare Beneficiaries | 64 |
| Total Submitted Charge Amount | 21646.75 |
| Total Medicare Allowed Amount | 11693.13 |
| Total Medicare Payment Amount | 7768.07 |
| Total Medicare Standardized Payment Amount | 8525.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 45 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 424.28 |
| Total Drug Medicare AllowedAmount | 235.43 |
| Total Drug Medicare PaymentAmount | 223.09 |
| Total Drug Medicare Standardized Payment Amount | 223.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 216 |
| Number Of Medicare Beneficiaries With Medical Services | 64 |
| Total Medical Submitted Charge Amount | 21222.47 |
| Total Medical Medicare Allowed Amount | 11457.7 |
| Total Medical Medicare Payment Amount | 7544.98 |
| Total Medical Medicare Standardized Payment Amount | 8302.51 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | 27 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 19 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0501 |