| National Provider Identifier [NPI]: | 1811074529 |
| Last Name Of The Provider | BUCK |
| First Name Of The Provider | TARA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 910 MALABAR RD SE |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | PALM BAY |
| Zip Code Of The Provider | 329073200 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 283 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 22160 |
| Total Medicare Allowed Amount | 12152.8 |
| Total Medicare Payment Amount | 8977.93 |
| Total Medicare Standardized Payment Amount | 10559.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 720 |
| Total Drug Medicare AllowedAmount | 346.97 |
| Total Drug Medicare PaymentAmount | 337.09 |
| Total Drug Medicare Standardized Payment Amount | 337.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 266 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 21440 |
| Total Medical Medicare Allowed Amount | 11805.83 |
| Total Medical Medicare Payment Amount | 8640.84 |
| Total Medical Medicare Standardized Payment Amount | 10222.01 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 72 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 91 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3642 |