| National Provider Identifier [NPI]: | 1700861424 |
| Last Name Of The Provider | JONES |
| First Name Of The Provider | MAUREEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4805 NE GLISAN ST. |
| Street Address 2 Of The Provider | SUITE 2E15 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972132933 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 204 |
| Number Of Medicare Beneficiaries | 121 |
| Total Submitted Charge Amount | 44611 |
| Total Medicare Allowed Amount | 12412.85 |
| Total Medicare Payment Amount | 8438.4 |
| Total Medicare Standardized Payment Amount | 10640.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 484 |
| Total Drug Medicare AllowedAmount | 297.7 |
| Total Drug Medicare PaymentAmount | 287.21 |
| Total Drug Medicare Standardized Payment Amount | 287.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 180 |
| Number Of Medicare Beneficiaries With Medical Services | 121 |
| Total Medical Submitted Charge Amount | 44127 |
| Total Medical Medicare Allowed Amount | 12115.15 |
| Total Medical Medicare Payment Amount | 8151.19 |
| Total Medical Medicare Standardized Payment Amount | 10353.61 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 83 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | 108 |
| Number Of Black or African American Beneficiaries | |
| 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 | 92 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0076 |