| National Provider Identifier [NPI]: | 1205822509 |
| Last Name Of The Provider | HEAD |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MSN,FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 TAYLOR ST |
| Street Address 2 Of The Provider | SUITE 8-A |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 292012942 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 788 |
| Number Of Medicare Beneficiaries | 222 |
| Total Submitted Charge Amount | 69984 |
| Total Medicare Allowed Amount | 36791.4 |
| Total Medicare Payment Amount | 26370.24 |
| Total Medicare Standardized Payment Amount | 34376.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 2074 |
| Total Drug Medicare AllowedAmount | 1770.37 |
| Total Drug Medicare PaymentAmount | 1733.6 |
| Total Drug Medicare Standardized Payment Amount | 1733.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 759 |
| Number Of Medicare Beneficiaries With Medical Services | 222 |
| Total Medical Submitted Charge Amount | 67910 |
| Total Medical Medicare Allowed Amount | 35021.03 |
| Total Medical Medicare Payment Amount | 24636.64 |
| Total Medical Medicare Standardized Payment Amount | 32642.77 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 158 |
| Number Of Male Beneficiaries | 64 |
| Number Of Non Hispanic White Beneficiaries | 144 |
| 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 | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0636 |