| National Provider Identifier [NPI]: | 1639125719 |
| Last Name Of The Provider | MCCANN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3515 RICHMOND RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755030711 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 183 |
| Number Of Medicare Beneficiaries | 44 |
| Total Submitted Charge Amount | 15360 |
| Total Medicare Allowed Amount | 5481.11 |
| Total Medicare Payment Amount | 3736.86 |
| Total Medicare Standardized Payment Amount | 4766.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 1011 |
| Total Drug Medicare AllowedAmount | 63.36 |
| Total Drug Medicare PaymentAmount | 49.66 |
| Total Drug Medicare Standardized Payment Amount | 49.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 130 |
| Number Of Medicare Beneficiaries With Medical Services | 44 |
| Total Medical Submitted Charge Amount | 14349 |
| Total Medical Medicare Allowed Amount | 5417.75 |
| Total Medical Medicare Payment Amount | 3687.2 |
| Total Medical Medicare Standardized Payment Amount | 4716.87 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 25 |
| Number Of Male Beneficiaries | 19 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| 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 | 27 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8851 |