| National Provider Identifier [NPI]: | 1366733164 |
| Last Name Of The Provider | COLE |
| First Name Of The Provider | ERICA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 711 AVIGNON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIDGELAND |
| Zip Code Of The Provider | 391575120 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1058 |
| Number Of Medicare Beneficiaries | 243 |
| Total Submitted Charge Amount | 108003 |
| Total Medicare Allowed Amount | 60721.59 |
| Total Medicare Payment Amount | 47345.48 |
| Total Medicare Standardized Payment Amount | 59148.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1032 |
| Total Drug Medicare AllowedAmount | 59.43 |
| Total Drug Medicare PaymentAmount | 30.78 |
| Total Drug Medicare Standardized Payment Amount | 30.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 1023 |
| Number Of Medicare Beneficiaries With Medical Services | 233 |
| Total Medical Submitted Charge Amount | 106971 |
| Total Medical Medicare Allowed Amount | 60662.16 |
| Total Medical Medicare Payment Amount | 47314.7 |
| Total Medical Medicare Standardized Payment Amount | 59117.8 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 168 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 175 |
| 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 | 75 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 69 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.7311 |