| National Provider Identifier [NPI]: | 1073590147 |
| Last Name Of The Provider | MARSHALL |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | APRN BC PSYCH NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 219 NORTH AVE |
| Street Address 2 Of The Provider | STE 201, HEALTHCARE SERVICES INC |
| City Of The Provider | LA FOLLETTE |
| Zip Code Of The Provider | 377662732 |
| 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 | 4 |
| Number Of Services | 443 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 26677 |
| Total Medicare Allowed Amount | 15115.12 |
| Total Medicare Payment Amount | 9807.68 |
| Total Medicare Standardized Payment Amount | 13464.4 |
| 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 | 4 |
| Number Of Medical Services | 443 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 26677 |
| Total Medical Medicare Allowed Amount | 15115.12 |
| Total Medical Medicare Payment Amount | 9807.68 |
| Total Medical Medicare Standardized Payment Amount | 13464.4 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 98 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| 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 | 15 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 30 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 10 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9955 |