| National Provider Identifier [NPI]: | 1215165311 |
| Last Name Of The Provider | BUSH |
| First Name Of The Provider | SARA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 HILLSIDE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PULASKI |
| Zip Code Of The Provider | 384784566 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1462 |
| Number Of Medicare Beneficiaries | 229 |
| Total Submitted Charge Amount | 176338 |
| Total Medicare Allowed Amount | 75170.53 |
| Total Medicare Payment Amount | 55471.25 |
| Total Medicare Standardized Payment Amount | 59758.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 182 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 6357 |
| Total Drug Medicare AllowedAmount | 1237.62 |
| Total Drug Medicare PaymentAmount | 1174.38 |
| Total Drug Medicare Standardized Payment Amount | 1174.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1280 |
| Number Of Medicare Beneficiaries With Medical Services | 229 |
| Total Medical Submitted Charge Amount | 169981 |
| Total Medical Medicare Allowed Amount | 73932.91 |
| Total Medical Medicare Payment Amount | 54296.87 |
| Total Medical Medicare Standardized Payment Amount | 58584.17 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 209 |
| 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 | 175 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1409 |