| National Provider Identifier [NPI]: | 1841516614 |
| Last Name Of The Provider | TOMASIEWICZ |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | NURSE PRACTITIONER |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 745 FLETCHER DRIVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | ELGIN |
| Zip Code Of The Provider | 60123 |
| 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 | 67 |
| Number Of Services | 7994 |
| Number Of Medicare Beneficiaries | 507 |
| Total Submitted Charge Amount | 696195.2 |
| Total Medicare Allowed Amount | 210809.36 |
| Total Medicare Payment Amount | 166894.04 |
| Total Medicare Standardized Payment Amount | 176325.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 2477 |
| Number Of Medicare Beneficiaries With Drug Services | 156 |
| Total Drug Submitted ChargeAmount | 59509.2 |
| Total Drug Medicare AllowedAmount | 45940.79 |
| Total Drug Medicare PaymentAmount | 38369.91 |
| Total Drug Medicare Standardized Payment Amount | 38369.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 5517 |
| Number Of Medicare Beneficiaries With Medical Services | 507 |
| Total Medical Submitted Charge Amount | 636686 |
| Total Medical Medicare Allowed Amount | 164868.57 |
| Total Medical Medicare Payment Amount | 128524.13 |
| Total Medical Medicare Standardized Payment Amount | 137955.9 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 312 |
| Number Of Male Beneficiaries | 195 |
| Number Of Non Hispanic White Beneficiaries | 492 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.0659 |