| National Provider Identifier [NPI]: | 1699772244 |
| Last Name Of The Provider | TELLE |
| First Name Of The Provider | TERRI |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6035 KENTUCKY DAM RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PADUCAH |
| Zip Code Of The Provider | 420039472 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 3513 |
| Number Of Medicare Beneficiaries | 632 |
| Total Submitted Charge Amount | 218630 |
| Total Medicare Allowed Amount | 129209.53 |
| Total Medicare Payment Amount | 86016.52 |
| Total Medicare Standardized Payment Amount | 94039.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 641 |
| Number Of Medicare Beneficiaries With Drug Services | 248 |
| Total Drug Submitted ChargeAmount | 22360 |
| Total Drug Medicare AllowedAmount | 10088.22 |
| Total Drug Medicare PaymentAmount | 9372.67 |
| Total Drug Medicare Standardized Payment Amount | 9372.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 2872 |
| Number Of Medicare Beneficiaries With Medical Services | 630 |
| Total Medical Submitted Charge Amount | 196270 |
| Total Medical Medicare Allowed Amount | 119121.31 |
| Total Medical Medicare Payment Amount | 76643.85 |
| Total Medical Medicare Standardized Payment Amount | 84666.71 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 298 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 421 |
| Number Of Male Beneficiaries | 211 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 567 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| 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 | 0.904 |