| National Provider Identifier [NPI]: | 1396936035 |
| Last Name Of The Provider | MCNALLY |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 227 EASTERN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUGUSTA |
| Zip Code Of The Provider | 043305951 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1287 |
| Number Of Medicare Beneficiaries | 411 |
| Total Submitted Charge Amount | 320435 |
| Total Medicare Allowed Amount | 201859.91 |
| Total Medicare Payment Amount | 147290.43 |
| Total Medicare Standardized Payment Amount | 152695.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 100160 |
| Total Drug Medicare AllowedAmount | 94697.55 |
| Total Drug Medicare PaymentAmount | 74200.06 |
| Total Drug Medicare Standardized Payment Amount | 74200.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1091 |
| Number Of Medicare Beneficiaries With Medical Services | 411 |
| Total Medical Submitted Charge Amount | 220275 |
| Total Medical Medicare Allowed Amount | 107162.36 |
| Total Medical Medicare Payment Amount | 73090.37 |
| Total Medical Medicare Standardized Payment Amount | 78495.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 252 |
| Number Of Male Beneficiaries | 159 |
| 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 | 260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 151 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.136 |