| National Provider Identifier [NPI]: | 1962405373 |
| Last Name Of The Provider | BRIDGEMAN |
| First Name Of The Provider | MEIKE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | NURSE PRACTITIONER |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 HOSPITAL DR |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | MC KENZIE |
| Zip Code Of The Provider | 382011649 |
| 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 | 72 |
| Number Of Services | 1065 |
| Number Of Medicare Beneficiaries | 204 |
| Total Submitted Charge Amount | 49467 |
| Total Medicare Allowed Amount | 17463.57 |
| Total Medicare Payment Amount | 14533.29 |
| Total Medicare Standardized Payment Amount | 16268.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 679 |
| Total Drug Medicare AllowedAmount | 37.42 |
| Total Drug Medicare PaymentAmount | 25.87 |
| Total Drug Medicare Standardized Payment Amount | 25.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 1031 |
| Number Of Medicare Beneficiaries With Medical Services | 204 |
| Total Medical Submitted Charge Amount | 48788 |
| Total Medical Medicare Allowed Amount | 17426.15 |
| Total Medical Medicare Payment Amount | 14507.42 |
| Total Medical Medicare Standardized Payment Amount | 16242.79 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 172 |
| 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 | 35 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 169 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 41 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0735 |