| National Provider Identifier [NPI]: | 1144250077 |
| Last Name Of The Provider | FOTIADIS |
| First Name Of The Provider | LILLY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9826 HIXSON PIKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SODDY DAISY |
| Zip Code Of The Provider | 373793517 |
| 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 | 17 |
| Number Of Services | 362 |
| Number Of Medicare Beneficiaries | 331 |
| Total Submitted Charge Amount | 387312 |
| Total Medicare Allowed Amount | 37722.38 |
| Total Medicare Payment Amount | 29360.68 |
| Total Medicare Standardized Payment Amount | 36229.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 362 |
| Number Of Medicare Beneficiaries With Medical Services | 331 |
| Total Medical Submitted Charge Amount | 387312 |
| Total Medical Medicare Allowed Amount | 37722.38 |
| Total Medical Medicare Payment Amount | 29360.68 |
| Total Medical Medicare Standardized Payment Amount | 36229.36 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 233 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 266 |
| 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 | 160 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 171 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7772 |