| National Provider Identifier [NPI]: | 1457515363 |
| Last Name Of The Provider | ALBANO |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3805 CHEROKEE ST NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | KENNESAW |
| Zip Code Of The Provider | 301442085 |
| 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 | 30 |
| Number Of Services | 473 |
| Number Of Medicare Beneficiaries | 225 |
| Total Submitted Charge Amount | 79525 |
| Total Medicare Allowed Amount | 33687.25 |
| Total Medicare Payment Amount | 23771.56 |
| Total Medicare Standardized Payment Amount | 28558.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 2551 |
| Total Drug Medicare AllowedAmount | 1317.66 |
| Total Drug Medicare PaymentAmount | 1288.23 |
| Total Drug Medicare Standardized Payment Amount | 1288.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 441 |
| Number Of Medicare Beneficiaries With Medical Services | 225 |
| Total Medical Submitted Charge Amount | 76974 |
| Total Medical Medicare Allowed Amount | 32369.59 |
| Total Medical Medicare Payment Amount | 22483.33 |
| Total Medical Medicare Standardized Payment Amount | 27270.18 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 171 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 184 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9206 |