| National Provider Identifier [NPI]: | 1013190974 |
| Last Name Of The Provider | TRAN |
| First Name Of The Provider | THERESA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 713 E BASIN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW CASTLE |
| Zip Code Of The Provider | 197204201 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 52 |
| Number Of Medicare Beneficiaries | 32 |
| Total Submitted Charge Amount | 2399.85 |
| Total Medicare Allowed Amount | 2238.56 |
| Total Medicare Payment Amount | 1587.8 |
| Total Medicare Standardized Payment Amount | 1817.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 314.85 |
| Total Drug Medicare AllowedAmount | 314.85 |
| Total Drug Medicare PaymentAmount | 308.55 |
| Total Drug Medicare Standardized Payment Amount | 308.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 37 |
| Number Of Medicare Beneficiaries With Medical Services | 32 |
| Total Medical Submitted Charge Amount | 2085 |
| Total Medical Medicare Allowed Amount | 1923.71 |
| Total Medical Medicare Payment Amount | 1279.25 |
| Total Medical Medicare Standardized Payment Amount | 1509.12 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 32 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 32 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.7854 |