| National Provider Identifier [NPI]: | 1609978048 |
| Last Name Of The Provider | BRANTLEY |
| First Name Of The Provider | DAYSHA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MSN, FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 902 HIGHWAY 13 SOUTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLLINWOOD |
| Zip Code Of The Provider | 38450 |
| 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 | 21 |
| Number Of Services | 1165 |
| Number Of Medicare Beneficiaries | 136 |
| Total Submitted Charge Amount | 68617 |
| Total Medicare Allowed Amount | 28049.52 |
| Total Medicare Payment Amount | 20102.51 |
| Total Medicare Standardized Payment Amount | 25111 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 580 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 5105 |
| Total Drug Medicare AllowedAmount | 277.13 |
| Total Drug Medicare PaymentAmount | 233.9 |
| Total Drug Medicare Standardized Payment Amount | 233.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 585 |
| Number Of Medicare Beneficiaries With Medical Services | 136 |
| Total Medical Submitted Charge Amount | 63512 |
| Total Medical Medicare Allowed Amount | 27772.39 |
| Total Medical Medicare Payment Amount | 19868.61 |
| Total Medical Medicare Standardized Payment Amount | 24877.1 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9018 |