| National Provider Identifier [NPI]: | 1437483849 |
| Last Name Of The Provider | TRA |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2140 KINGSLEY AVE STE 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORANGE PARK |
| Zip Code Of The Provider | 320735129 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 5409 |
| Number Of Medicare Beneficiaries | 1003 |
| Total Submitted Charge Amount | 486105.2 |
| Total Medicare Allowed Amount | 310035.16 |
| Total Medicare Payment Amount | 235019.4 |
| Total Medicare Standardized Payment Amount | 274240.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 5409 |
| Number Of Medicare Beneficiaries With Medical Services | 1003 |
| Total Medical Submitted Charge Amount | 486105.2 |
| Total Medical Medicare Allowed Amount | 310035.16 |
| Total Medical Medicare Payment Amount | 235019.4 |
| Total Medical Medicare Standardized Payment Amount | 274240.23 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 290 |
| Number Of Beneficiaries Age Greater 84 | 455 |
| Number Of Female Beneficiaries | 689 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 842 |
| Number Of Black or African American Beneficiaries | 118 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 339 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 664 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 68 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2306 |