| National Provider Identifier [NPI]: | 1699750091 |
| Last Name Of The Provider | VAUGHAN |
| First Name Of The Provider | JANE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3220 BLUFF CREEK DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652013525 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1280 |
| Number Of Medicare Beneficiaries | 964 |
| Total Submitted Charge Amount | 138876.58 |
| Total Medicare Allowed Amount | 112704.48 |
| Total Medicare Payment Amount | 79639.26 |
| Total Medicare Standardized Payment Amount | 104461.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 443 |
| Total Drug Medicare AllowedAmount | 32.68 |
| Total Drug Medicare PaymentAmount | 14.94 |
| Total Drug Medicare Standardized Payment Amount | 14.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1254 |
| Number Of Medicare Beneficiaries With Medical Services | 964 |
| Total Medical Submitted Charge Amount | 138433.58 |
| Total Medical Medicare Allowed Amount | 112671.8 |
| Total Medical Medicare Payment Amount | 79624.32 |
| Total Medical Medicare Standardized Payment Amount | 104446.1 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 376 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 406 |
| Number Of Male Beneficiaries | 558 |
| Number Of Non Hispanic White Beneficiaries | 928 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 900 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4791 |