| National Provider Identifier [NPI]: | 1750687422 |
| Last Name Of The Provider | ELDRED |
| First Name Of The Provider | STORMIEE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | FNP- BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 133 HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | CARTHAGE |
| Zip Code Of The Provider | 370304004 |
| 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 | 22 |
| Number Of Services | 941 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 47204 |
| Total Medicare Allowed Amount | 25026.77 |
| Total Medicare Payment Amount | 12540.36 |
| Total Medicare Standardized Payment Amount | 17992.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 518 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 11260 |
| Total Drug Medicare AllowedAmount | 1585.51 |
| Total Drug Medicare PaymentAmount | 945.85 |
| Total Drug Medicare Standardized Payment Amount | 945.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 423 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 35944 |
| Total Medical Medicare Allowed Amount | 23441.26 |
| Total Medical Medicare Payment Amount | 11594.51 |
| Total Medical Medicare Standardized Payment Amount | 17046.8 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 31 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3497 |