| National Provider Identifier [NPI]: | 1942465570 |
| Last Name Of The Provider | HOLLIS |
| First Name Of The Provider | BRENDA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MSN,FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1716 PARR AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | DYERSBURG |
| Zip Code Of The Provider | 380242073 |
| 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 | 17 |
| Number Of Services | 198 |
| Number Of Medicare Beneficiaries | 38 |
| Total Submitted Charge Amount | 4226 |
| Total Medicare Allowed Amount | 1324.21 |
| Total Medicare Payment Amount | 1051.33 |
| Total Medicare Standardized Payment Amount | 1016.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 110 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1355 |
| Total Drug Medicare AllowedAmount | 69.3 |
| Total Drug Medicare PaymentAmount | 50.05 |
| Total Drug Medicare Standardized Payment Amount | 50.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 88 |
| Number Of Medicare Beneficiaries With Medical Services | 38 |
| Total Medical Submitted Charge Amount | 2871 |
| Total Medical Medicare Allowed Amount | 1254.91 |
| Total Medical Medicare Payment Amount | 1001.28 |
| Total Medical Medicare Standardized Payment Amount | 966.42 |
| Average Age Of Beneficiaries | 54 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 20 |
| Number Of Male Beneficiaries | 18 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2664 |