| National Provider Identifier [NPI]: | 1356521991 |
| Last Name Of The Provider | CARRANZA |
| First Name Of The Provider | DAFNIS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 MEDICAL PARK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUMBOLDT |
| Zip Code Of The Provider | 383433034 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 23067 |
| Number Of Medicare Beneficiaries | 2436 |
| Total Submitted Charge Amount | 2915187.63 |
| Total Medicare Allowed Amount | 1934691.98 |
| Total Medicare Payment Amount | 1455656.42 |
| Total Medicare Standardized Payment Amount | 1551591.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 474 |
| Number Of Medicare Beneficiaries With Drug Services | 220 |
| Total Drug Submitted ChargeAmount | 109675 |
| Total Drug Medicare AllowedAmount | 98049.34 |
| Total Drug Medicare PaymentAmount | 76350.33 |
| Total Drug Medicare Standardized Payment Amount | 76350.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 22593 |
| Number Of Medicare Beneficiaries With Medical Services | 2436 |
| Total Medical Submitted Charge Amount | 2805512.63 |
| Total Medical Medicare Allowed Amount | 1836642.64 |
| Total Medical Medicare Payment Amount | 1379306.09 |
| Total Medical Medicare Standardized Payment Amount | 1475241.65 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 1221 |
| Number Of Beneficiaries Age 75 to 84 | 843 |
| Number Of Beneficiaries Age Greater 84 | 276 |
| Number Of Female Beneficiaries | 1277 |
| Number Of Male Beneficiaries | 1159 |
| Number Of Non Hispanic White Beneficiaries | 2392 |
| Number Of Black or African American Beneficiaries | 22 |
| 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 | 2331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 105 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9259 |