| National Provider Identifier [NPI]: | 1639116767 |
| Last Name Of The Provider | WARSING |
| First Name Of The Provider | JODIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | AP MHCNS |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2120 MADISON AVE |
| Street Address 2 Of The Provider | STE 404 |
| City Of The Provider | GRANITE CITY |
| Zip Code Of The Provider | 62040 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Certified Clinical Nurse Specialist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 1945 |
| Number Of Medicare Beneficiaries | 1055 |
| Total Submitted Charge Amount | 202465 |
| Total Medicare Allowed Amount | 116889.27 |
| Total Medicare Payment Amount | 82174.88 |
| Total Medicare Standardized Payment Amount | 103733.87 |
| 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 | 10 |
| Number Of Medical Services | 1945 |
| Number Of Medicare Beneficiaries With Medical Services | 1055 |
| Total Medical Submitted Charge Amount | 202465 |
| Total Medical Medicare Allowed Amount | 116889.27 |
| Total Medical Medicare Payment Amount | 82174.88 |
| Total Medical Medicare Standardized Payment Amount | 103733.87 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 275 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 653 |
| Number Of Male Beneficiaries | 402 |
| Number Of Non Hispanic White Beneficiaries | 886 |
| Number Of Black or African American Beneficiaries | 151 |
| 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 | 174 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 881 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 70 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 60 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 50 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0296 |