| National Provider Identifier [NPI]: | 1417111246 |
| Last Name Of The Provider | GOTTSCHALL |
| First Name Of The Provider | COURTNEY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 179 HANCOCK ST |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | GALLATIN |
| Zip Code Of The Provider | 370666346 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 7765 |
| Number Of Medicare Beneficiaries | 178 |
| Total Submitted Charge Amount | 454982 |
| Total Medicare Allowed Amount | 203759.02 |
| Total Medicare Payment Amount | 182146.95 |
| Total Medicare Standardized Payment Amount | 159877.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 131 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1495 |
| Total Drug Medicare AllowedAmount | 69.19 |
| Total Drug Medicare PaymentAmount | 49.37 |
| Total Drug Medicare Standardized Payment Amount | 49.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 7634 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 453487 |
| Total Medical Medicare Allowed Amount | 203689.83 |
| Total Medical Medicare Payment Amount | 182097.58 |
| Total Medical Medicare Standardized Payment Amount | 159828.31 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 103 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 157 |
| 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 | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4022 |