| National Provider Identifier [NPI]: | 1518242064 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | JEAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2251 CONNECTICUT AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | SARTELL |
| Zip Code Of The Provider | 563772486 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 709 |
| Number Of Medicare Beneficiaries | 90 |
| Total Submitted Charge Amount | 42825 |
| Total Medicare Allowed Amount | 13742.62 |
| Total Medicare Payment Amount | 9967.53 |
| Total Medicare Standardized Payment Amount | 12203.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 352 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 478 |
| Total Drug Medicare AllowedAmount | 151.38 |
| Total Drug Medicare PaymentAmount | 121.43 |
| Total Drug Medicare Standardized Payment Amount | 121.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 357 |
| Number Of Medicare Beneficiaries With Medical Services | 90 |
| Total Medical Submitted Charge Amount | 42347 |
| Total Medical Medicare Allowed Amount | 13591.24 |
| Total Medical Medicare Payment Amount | 9846.1 |
| Total Medical Medicare Standardized Payment Amount | 12082.06 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | 79 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 38 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0493 |