| National Provider Identifier [NPI]: | 1073576104 |
| Last Name Of The Provider | WHITTEN |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | A.P.N. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2067 UPLAND DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRANKLIN |
| Zip Code Of The Provider | 370674090 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Certified Clinical Nurse Specialist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 952 |
| Number Of Medicare Beneficiaries | 504 |
| Total Submitted Charge Amount | 125368.66 |
| Total Medicare Allowed Amount | 72054.79 |
| Total Medicare Payment Amount | 54404.26 |
| Total Medicare Standardized Payment Amount | 67824.56 |
| 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 | 11 |
| Number Of Medical Services | 952 |
| Number Of Medicare Beneficiaries With Medical Services | 504 |
| Total Medical Submitted Charge Amount | 125368.66 |
| Total Medical Medicare Allowed Amount | 72054.79 |
| Total Medical Medicare Payment Amount | 54404.26 |
| Total Medical Medicare Standardized Payment Amount | 67824.56 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 92 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 198 |
| Number Of Female Beneficiaries | 352 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | 454 |
| 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 | 117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 387 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 70 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 54 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.084 |