| National Provider Identifier [NPI]: | 1467429746 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | TRACEY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 230 N MAPLE AVE |
| Street Address 2 Of The Provider | SUITE B1 #329 |
| City Of The Provider | MARLTON |
| Zip Code Of The Provider | 080539400 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 1632 |
| Number Of Medicare Beneficiaries | 614 |
| Total Submitted Charge Amount | 179583.39 |
| Total Medicare Allowed Amount | 175898.09 |
| Total Medicare Payment Amount | 135650.1 |
| Total Medicare Standardized Payment Amount | 118741.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 1632 |
| Number Of Medicare Beneficiaries With Medical Services | 614 |
| Total Medical Submitted Charge Amount | 179583.39 |
| Total Medical Medicare Allowed Amount | 175898.09 |
| Total Medical Medicare Payment Amount | 135650.1 |
| Total Medical Medicare Standardized Payment Amount | 118741.56 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 171 |
| Number Of Beneficiaries Age 75 to 84 | 194 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 340 |
| Number Of Male Beneficiaries | 274 |
| Number Of Non Hispanic White Beneficiaries | 465 |
| Number Of Black or African American Beneficiaries | 118 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 507 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 34 |
| Average HCC Risk Score Of Beneficiaries | 2.9077 |