| National Provider Identifier [NPI]: | 1801102553 |
| Last Name Of The Provider | WILLIAMS |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3502 9TH ST |
| Street Address 2 Of The Provider | SUITE 170 |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794153300 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1560 |
| Number Of Medicare Beneficiaries | 336 |
| Total Submitted Charge Amount | 107653 |
| Total Medicare Allowed Amount | 47875.8 |
| Total Medicare Payment Amount | 36809.7 |
| Total Medicare Standardized Payment Amount | 45732.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 551 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 6047 |
| Total Drug Medicare AllowedAmount | 1663.62 |
| Total Drug Medicare PaymentAmount | 1494.28 |
| Total Drug Medicare Standardized Payment Amount | 1494.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1009 |
| Number Of Medicare Beneficiaries With Medical Services | 336 |
| Total Medical Submitted Charge Amount | 101606 |
| Total Medical Medicare Allowed Amount | 46212.18 |
| Total Medical Medicare Payment Amount | 35315.42 |
| Total Medical Medicare Standardized Payment Amount | 44238.67 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 156 |
| Number Of Non Hispanic White Beneficiaries | 235 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 224 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7235 |