| National Provider Identifier [NPI]: | 1457304073 |
| Last Name Of The Provider | TILSON |
| First Name Of The Provider | CATHERINE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 PIEDMONT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRISTOL |
| Zip Code Of The Provider | 242014167 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 658 |
| Number Of Medicare Beneficiaries | 319 |
| Total Submitted Charge Amount | 18598.56 |
| Total Medicare Allowed Amount | 15486.52 |
| Total Medicare Payment Amount | 15093.34 |
| Total Medicare Standardized Payment Amount | 15512.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 301 |
| Number Of Medicare Beneficiaries With Drug Services | 286 |
| Total Drug Submitted ChargeAmount | 9615.71 |
| Total Drug Medicare AllowedAmount | 6750.57 |
| Total Drug Medicare PaymentAmount | 6615.39 |
| Total Drug Medicare Standardized Payment Amount | 6615.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 357 |
| Number Of Medicare Beneficiaries With Medical Services | 317 |
| Total Medical Submitted Charge Amount | 8982.85 |
| Total Medical Medicare Allowed Amount | 8735.95 |
| Total Medical Medicare Payment Amount | 8477.95 |
| Total Medical Medicare Standardized Payment Amount | 8897.38 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 120 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 127 |
| Number Of Non Hispanic White Beneficiaries | 303 |
| 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 | 243 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8387 |