| National Provider Identifier [NPI]: | 1740273085 |
| Last Name Of The Provider | JONES |
| First Name Of The Provider | SHIRLEY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6856 103RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322106877 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 1448 |
| Number Of Medicare Beneficiaries | 355 |
| Total Submitted Charge Amount | 274126.15 |
| Total Medicare Allowed Amount | 92104.87 |
| Total Medicare Payment Amount | 66967.36 |
| Total Medicare Standardized Payment Amount | 68858.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 166 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 12181.74 |
| Total Drug Medicare AllowedAmount | 4985.22 |
| Total Drug Medicare PaymentAmount | 4786.93 |
| Total Drug Medicare Standardized Payment Amount | 4786.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1282 |
| Number Of Medicare Beneficiaries With Medical Services | 355 |
| Total Medical Submitted Charge Amount | 261944.41 |
| Total Medical Medicare Allowed Amount | 87119.65 |
| Total Medical Medicare Payment Amount | 62180.43 |
| Total Medical Medicare Standardized Payment Amount | 64071.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 152 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 112 |
| Number Of Non Hispanic White Beneficiaries | 306 |
| Number Of Black or African American Beneficiaries | 36 |
| 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 | 317 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1561 |