| National Provider Identifier [NPI]: | 1861741100 |
| Last Name Of The Provider | COAR |
| First Name Of The Provider | JAEKEA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MSN,APRN, FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3051 WATSON BLVD |
| Street Address 2 Of The Provider | HOUSTON ORTHOPAEDIC SURGERY AND SPORTS |
| City Of The Provider | WARNER ROBINS |
| Zip Code Of The Provider | 31093 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 176 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 9195.51 |
| Total Medicare Allowed Amount | 6962.81 |
| Total Medicare Payment Amount | 5368.54 |
| Total Medicare Standardized Payment Amount | 6340.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2588.51 |
| Total Drug Medicare AllowedAmount | 1857.36 |
| Total Drug Medicare PaymentAmount | 1695.68 |
| Total Drug Medicare Standardized Payment Amount | 1695.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 123 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 6607 |
| Total Medical Medicare Allowed Amount | 5105.45 |
| Total Medical Medicare Payment Amount | 3672.86 |
| Total Medical Medicare Standardized Payment Amount | 4645.17 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 61 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | 87 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| 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 | 17 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9105 |