| National Provider Identifier [NPI]: | 1407895618 |
| Last Name Of The Provider | JEFFERSON-SABOOR |
| First Name Of The Provider | ANDREA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MSN, FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2140 PEACHTREE RD NW |
| Street Address 2 Of The Provider | SUITE 232 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303091314 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 949 |
| Number Of Medicare Beneficiaries | 42 |
| Total Submitted Charge Amount | 77940 |
| Total Medicare Allowed Amount | 32716.14 |
| Total Medicare Payment Amount | 27590.16 |
| Total Medicare Standardized Payment Amount | 33287.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 116 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 4604 |
| Total Drug Medicare AllowedAmount | 2562.22 |
| Total Drug Medicare PaymentAmount | 2387.1 |
| Total Drug Medicare Standardized Payment Amount | 2387.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 833 |
| Number Of Medicare Beneficiaries With Medical Services | 42 |
| Total Medical Submitted Charge Amount | 73336 |
| Total Medical Medicare Allowed Amount | 30153.92 |
| Total Medical Medicare Payment Amount | 25203.06 |
| Total Medical Medicare Standardized Payment Amount | 30899.91 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 20 |
| Number Of Male Beneficiaries | 22 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| 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 | 45 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7899 |