| National Provider Identifier [NPI]: | 1619954260 |
| Last Name Of The Provider | CORNETT |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 JARRETT WHITE RD |
| Street Address 2 Of The Provider | TRIPLER ARMY MEDICAL CENTER |
| City Of The Provider | TRIPLER AMC |
| Zip Code Of The Provider | 968595001 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 630 |
| Number Of Medicare Beneficiaries | 563 |
| Total Submitted Charge Amount | 677090 |
| Total Medicare Allowed Amount | 63884.19 |
| Total Medicare Payment Amount | 47564.88 |
| Total Medicare Standardized Payment Amount | 55224.67 |
| 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 | 15 |
| Number Of Medical Services | 630 |
| Number Of Medicare Beneficiaries With Medical Services | 563 |
| Total Medical Submitted Charge Amount | 677090 |
| Total Medical Medicare Allowed Amount | 63884.19 |
| Total Medical Medicare Payment Amount | 47564.88 |
| Total Medical Medicare Standardized Payment Amount | 55224.67 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 294 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | 544 |
| 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 | 484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3734 |