| National Provider Identifier [NPI]: | 1346324431 |
| Last Name Of The Provider | TUCKER |
| First Name Of The Provider | POLLY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3001 LAUDERDALE DRIVE |
| Street Address 2 Of The Provider | MINUTECLINIC |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232337612 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 372 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 13994.68 |
| Total Medicare Allowed Amount | 12806.27 |
| Total Medicare Payment Amount | 10123.59 |
| Total Medicare Standardized Payment Amount | 11756.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 3715.68 |
| Total Drug Medicare AllowedAmount | 3715.68 |
| Total Drug Medicare PaymentAmount | 3610.17 |
| Total Drug Medicare Standardized Payment Amount | 3610.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 236 |
| Number Of Medicare Beneficiaries With Medical Services | 194 |
| Total Medical Submitted Charge Amount | 10279 |
| Total Medical Medicare Allowed Amount | 9090.59 |
| Total Medical Medicare Payment Amount | 6513.42 |
| Total Medical Medicare Standardized Payment Amount | 8146.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 129 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | 183 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 11 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6909 |