| National Provider Identifier [NPI]: | 1700865847 |
| Last Name Of The Provider | RICKARD |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MSN,APRN,BC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 557 W PARK PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | HENDERSON |
| Zip Code Of The Provider | 383402027 |
| 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 | 63 |
| Number Of Services | 1242 |
| Number Of Medicare Beneficiaries | 261 |
| Total Submitted Charge Amount | 31351.5 |
| Total Medicare Allowed Amount | 14489.32 |
| Total Medicare Payment Amount | 9575.79 |
| Total Medicare Standardized Payment Amount | 14439.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 275 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 2149 |
| Total Drug Medicare AllowedAmount | 360.29 |
| Total Drug Medicare PaymentAmount | 245.02 |
| Total Drug Medicare Standardized Payment Amount | 245.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 967 |
| Number Of Medicare Beneficiaries With Medical Services | 257 |
| Total Medical Submitted Charge Amount | 29202.5 |
| Total Medical Medicare Allowed Amount | 14129.03 |
| Total Medical Medicare Payment Amount | 9330.77 |
| Total Medical Medicare Standardized Payment Amount | 14194.12 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 231 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2628 |