| National Provider Identifier [NPI]: | 1972767739 |
| Last Name Of The Provider | TANTARELLI |
| First Name Of The Provider | JENIFER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1154 MONTGOMERY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954054816 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 447 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 56675 |
| Total Medicare Allowed Amount | 32529.87 |
| Total Medicare Payment Amount | 25453.65 |
| Total Medicare Standardized Payment Amount | 29145.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 447 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 56675 |
| Total Medical Medicare Allowed Amount | 32529.87 |
| Total Medical Medicare Payment Amount | 25453.65 |
| Total Medical Medicare Standardized Payment Amount | 29145.97 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | 181 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 47 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.685 |