| National Provider Identifier [NPI]: | 1104265826 |
| Last Name Of The Provider | BROWN |
| First Name Of The Provider | TISHA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | APRN, FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1010 HIGHWAY 17 N |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH MYRTLE BEACH |
| Zip Code Of The Provider | 295822806 |
| 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 | 26 |
| Number Of Services | 968 |
| Number Of Medicare Beneficiaries | 560 |
| Total Submitted Charge Amount | 46663.36 |
| Total Medicare Allowed Amount | 40975.2 |
| Total Medicare Payment Amount | 30063.74 |
| Total Medicare Standardized Payment Amount | 37048.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 269 |
| Number Of Medicare Beneficiaries With Drug Services | 243 |
| Total Drug Submitted ChargeAmount | 7290.36 |
| Total Drug Medicare AllowedAmount | 7231.08 |
| Total Drug Medicare PaymentAmount | 7059.56 |
| Total Drug Medicare Standardized Payment Amount | 7059.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 699 |
| Number Of Medicare Beneficiaries With Medical Services | 559 |
| Total Medical Submitted Charge Amount | 39373 |
| Total Medical Medicare Allowed Amount | 33744.12 |
| Total Medical Medicare Payment Amount | 23004.18 |
| Total Medical Medicare Standardized Payment Amount | 29989.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 389 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 332 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 543 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 545 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.7463 |