| National Provider Identifier [NPI]: | 1609100536 |
| Last Name Of The Provider | LAWRENCE |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | APN, FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1265 UNION AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381043415 |
| 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 | 13 |
| Number Of Services | 3205 |
| Number Of Medicare Beneficiaries | 53 |
| Total Submitted Charge Amount | 98438 |
| Total Medicare Allowed Amount | 73658.11 |
| Total Medicare Payment Amount | 54804.79 |
| Total Medicare Standardized Payment Amount | 71179.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1354 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 8402 |
| Total Drug Medicare AllowedAmount | 6648.62 |
| Total Drug Medicare PaymentAmount | 5040.88 |
| Total Drug Medicare Standardized Payment Amount | 5040.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 1851 |
| Number Of Medicare Beneficiaries With Medical Services | 53 |
| Total Medical Submitted Charge Amount | 90036 |
| Total Medical Medicare Allowed Amount | 67009.49 |
| Total Medical Medicare Payment Amount | 49763.91 |
| Total Medical Medicare Standardized Payment Amount | 66138.34 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 42 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1032 |