| National Provider Identifier [NPI]: | 1487644134 |
| Last Name Of The Provider | NOTSCH |
| First Name Of The Provider | JEANNE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 CENTRACARE CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT CLOUD |
| Zip Code Of The Provider | 563035000 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 591 |
| Number Of Medicare Beneficiaries | 150 |
| Total Submitted Charge Amount | 77832.25 |
| Total Medicare Allowed Amount | 28215.78 |
| Total Medicare Payment Amount | 21109.01 |
| Total Medicare Standardized Payment Amount | 25657.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 185 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1001.75 |
| Total Drug Medicare AllowedAmount | 601.34 |
| Total Drug Medicare PaymentAmount | 577.88 |
| Total Drug Medicare Standardized Payment Amount | 577.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 406 |
| Number Of Medicare Beneficiaries With Medical Services | 150 |
| Total Medical Submitted Charge Amount | 76830.5 |
| Total Medical Medicare Allowed Amount | 27614.44 |
| Total Medical Medicare Payment Amount | 20531.13 |
| Total Medical Medicare Standardized Payment Amount | 25079.42 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 135 |
| 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 | 75 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 36 |
| Percent Of With Ischemic Heart Disease | 9 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0389 |