| National Provider Identifier [NPI]: | 1679765465 |
| Last Name Of The Provider | OPPENHEIM |
| First Name Of The Provider | JILLIAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APRN BC FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 HIGHLAND AVE |
| Street Address 2 Of The Provider | STE. 101 |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 019702185 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 242 |
| Number Of Medicare Beneficiaries | 128 |
| Total Submitted Charge Amount | 44123 |
| Total Medicare Allowed Amount | 16049.81 |
| Total Medicare Payment Amount | 11449.06 |
| Total Medicare Standardized Payment Amount | 13255.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 651 |
| Total Drug Medicare AllowedAmount | 396.14 |
| Total Drug Medicare PaymentAmount | 388.08 |
| Total Drug Medicare Standardized Payment Amount | 388.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 227 |
| Number Of Medicare Beneficiaries With Medical Services | 128 |
| Total Medical Submitted Charge Amount | 43472 |
| Total Medical Medicare Allowed Amount | 15653.67 |
| Total Medical Medicare Payment Amount | 11060.98 |
| Total Medical Medicare Standardized Payment Amount | 12867.62 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 23 |
| 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 | 78 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2717 |