| National Provider Identifier [NPI]: | 1699855007 |
| Last Name Of The Provider | COLLOPY |
| First Name Of The Provider | JANET |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 GALE STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILLIAMSFIELD |
| Zip Code Of The Provider | 61489 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 892 |
| Number Of Medicare Beneficiaries | 167 |
| Total Submitted Charge Amount | 69693 |
| Total Medicare Allowed Amount | 33141.37 |
| Total Medicare Payment Amount | 22259.62 |
| Total Medicare Standardized Payment Amount | 27643.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 4413 |
| Total Drug Medicare AllowedAmount | 3567.38 |
| Total Drug Medicare PaymentAmount | 3452.39 |
| Total Drug Medicare Standardized Payment Amount | 3452.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 766 |
| Number Of Medicare Beneficiaries With Medical Services | 167 |
| Total Medical Submitted Charge Amount | 65280 |
| Total Medical Medicare Allowed Amount | 29573.99 |
| Total Medical Medicare Payment Amount | 18807.23 |
| Total Medical Medicare Standardized Payment Amount | 24190.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7427 |