| National Provider Identifier [NPI]: | 1275893372 |
| Last Name Of The Provider | CARPENTER |
| First Name Of The Provider | TERESA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MSN, ACNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 S TRYON ST |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | CHARLOTTE |
| Zip Code Of The Provider | 282034239 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 5701 |
| Number Of Medicare Beneficiaries | 173 |
| Total Submitted Charge Amount | 446043 |
| Total Medicare Allowed Amount | 101035.65 |
| Total Medicare Payment Amount | 78000.91 |
| Total Medicare Standardized Payment Amount | 81750.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 34 |
| Number Of Drug Services | 5079 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 366518 |
| Total Drug Medicare AllowedAmount | 78484.56 |
| Total Drug Medicare PaymentAmount | 61063.48 |
| Total Drug Medicare Standardized Payment Amount | 61063.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 622 |
| Number Of Medicare Beneficiaries With Medical Services | 173 |
| Total Medical Submitted Charge Amount | 79525 |
| Total Medical Medicare Allowed Amount | 22551.09 |
| Total Medical Medicare Payment Amount | 16937.43 |
| Total Medical Medicare Standardized Payment Amount | 20686.86 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 92 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 124 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 147 |
| 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 | 157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 68 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.8058 |