| National Provider Identifier [NPI]: | 1578621157 |
| Last Name Of The Provider | HOLLCRAFT |
| First Name Of The Provider | JACQUELINE |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 251 COHASSET RD |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | CHICO |
| Zip Code Of The Provider | 95926 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4562 |
| Number Of Medicare Beneficiaries | 804 |
| Total Submitted Charge Amount | 630201 |
| Total Medicare Allowed Amount | 214958.25 |
| Total Medicare Payment Amount | 161013.72 |
| Total Medicare Standardized Payment Amount | 177147.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 2632 |
| Total Drug Medicare AllowedAmount | 1039.19 |
| Total Drug Medicare PaymentAmount | 814.71 |
| Total Drug Medicare Standardized Payment Amount | 814.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 4530 |
| Number Of Medicare Beneficiaries With Medical Services | 804 |
| Total Medical Submitted Charge Amount | 627569 |
| Total Medical Medicare Allowed Amount | 213919.06 |
| Total Medical Medicare Payment Amount | 160199.01 |
| Total Medical Medicare Standardized Payment Amount | 176332.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 404 |
| Number Of Beneficiaries Age 75 to 84 | 257 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 489 |
| Number Of Male Beneficiaries | 315 |
| Number Of Non Hispanic White Beneficiaries | 775 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 753 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8139 |