| National Provider Identifier [NPI]: | 1104266352 |
| Last Name Of The Provider | TALLEY |
| First Name Of The Provider | PRISCILLA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | FNP-MSN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 223 E JACKSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | JONESBORO |
| Zip Code Of The Provider | 724013119 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 293 |
| Number Of Medicare Beneficiaries | 141 |
| Total Submitted Charge Amount | 25157 |
| Total Medicare Allowed Amount | 14049.63 |
| Total Medicare Payment Amount | 10149.33 |
| Total Medicare Standardized Payment Amount | 13275.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 322 |
| Total Drug Medicare AllowedAmount | 35.47 |
| Total Drug Medicare PaymentAmount | 31.71 |
| Total Drug Medicare Standardized Payment Amount | 31.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 259 |
| Number Of Medicare Beneficiaries With Medical Services | 141 |
| Total Medical Submitted Charge Amount | 24835 |
| Total Medical Medicare Allowed Amount | 14014.16 |
| Total Medical Medicare Payment Amount | 10117.62 |
| Total Medical Medicare Standardized Payment Amount | 13243.58 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 108 |
| 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 | 52 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3088 |