| National Provider Identifier [NPI]: | 1518104579 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | VICKI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1238 NW BROAD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MURFREESBORO |
| Zip Code Of The Provider | 371291713 |
| 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 | 27 |
| Number Of Services | 356 |
| Number Of Medicare Beneficiaries | 42 |
| Total Submitted Charge Amount | 26848.8 |
| Total Medicare Allowed Amount | 13053.62 |
| Total Medicare Payment Amount | 8265.85 |
| Total Medicare Standardized Payment Amount | 10855.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 890.06 |
| Total Drug Medicare AllowedAmount | 131.89 |
| Total Drug Medicare PaymentAmount | 106.07 |
| Total Drug Medicare Standardized Payment Amount | 106.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 290 |
| Number Of Medicare Beneficiaries With Medical Services | 42 |
| Total Medical Submitted Charge Amount | 25958.74 |
| Total Medical Medicare Allowed Amount | 12921.73 |
| Total Medical Medicare Payment Amount | 8159.78 |
| Total Medical Medicare Standardized Payment Amount | 10749.77 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 23 |
| Number Of Male Beneficiaries | 19 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | |
| 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 | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3794 |