| National Provider Identifier [NPI]: | 1073826483 |
| Last Name Of The Provider | MCCOY |
| First Name Of The Provider | CARRIE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 FORT SANDERS WEST BLVD |
| Street Address 2 Of The Provider | MOB 1, SUITE 304 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379223357 |
| 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 | 74 |
| Number Of Services | 749 |
| Number Of Medicare Beneficiaries | 233 |
| Total Submitted Charge Amount | 54519 |
| Total Medicare Allowed Amount | 24493.52 |
| Total Medicare Payment Amount | 18397.04 |
| Total Medicare Standardized Payment Amount | 22942.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 217 |
| Total Drug Medicare AllowedAmount | 152.01 |
| Total Drug Medicare PaymentAmount | 136.25 |
| Total Drug Medicare Standardized Payment Amount | 136.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 710 |
| Number Of Medicare Beneficiaries With Medical Services | 233 |
| Total Medical Submitted Charge Amount | 54302 |
| Total Medical Medicare Allowed Amount | 24341.51 |
| Total Medical Medicare Payment Amount | 18260.79 |
| Total Medical Medicare Standardized Payment Amount | 22805.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | 216 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 221 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9218 |