| National Provider Identifier [NPI]: | 1891028056 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2240 SUTHERLAND AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379192333 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 129 |
| Number Of Medicare Beneficiaries | 83 |
| Total Submitted Charge Amount | 6913.79 |
| Total Medicare Allowed Amount | 5912.27 |
| Total Medicare Payment Amount | 4152.05 |
| Total Medicare Standardized Payment Amount | 5606.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 773.8 |
| Total Drug Medicare AllowedAmount | 644.66 |
| Total Drug Medicare PaymentAmount | 631.71 |
| Total Drug Medicare Standardized Payment Amount | 631.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 108 |
| Number Of Medicare Beneficiaries With Medical Services | 83 |
| Total Medical Submitted Charge Amount | 6139.99 |
| Total Medical Medicare Allowed Amount | 5267.61 |
| Total Medical Medicare Payment Amount | 3520.34 |
| Total Medical Medicare Standardized Payment Amount | 4974.6 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 17 |
| 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 | 68 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| 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 | 24 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8309 |