| National Provider Identifier [NPI]: | 1265567952 |
| Last Name Of The Provider | HORNER |
| First Name Of The Provider | JILLIAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6685 GUNPARK DR |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | BOULDER |
| Zip Code Of The Provider | 803013388 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1079 |
| Number Of Medicare Beneficiaries | 200 |
| Total Submitted Charge Amount | 63572.2 |
| Total Medicare Allowed Amount | 43268.52 |
| Total Medicare Payment Amount | 34143.8 |
| Total Medicare Standardized Payment Amount | 34260.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 392 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 3004.2 |
| Total Drug Medicare AllowedAmount | 2739.06 |
| Total Drug Medicare PaymentAmount | 2652.02 |
| Total Drug Medicare Standardized Payment Amount | 2652.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 687 |
| Number Of Medicare Beneficiaries With Medical Services | 200 |
| Total Medical Submitted Charge Amount | 60568 |
| Total Medical Medicare Allowed Amount | 40529.46 |
| Total Medical Medicare Payment Amount | 31491.78 |
| Total Medical Medicare Standardized Payment Amount | 31608.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 188 |
| 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 | 184 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 9 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7874 |