| National Provider Identifier [NPI]: | 1255382388 |
| Last Name Of The Provider | BEUERLEIN |
| First Name Of The Provider | JOHNNA |
| 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 | 176C W UNIVERSITY PKWY # C |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 383051616 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 411 |
| Number Of Medicare Beneficiaries | 104 |
| Total Submitted Charge Amount | 23510.01 |
| Total Medicare Allowed Amount | 14844.65 |
| Total Medicare Payment Amount | 9503.44 |
| Total Medicare Standardized Payment Amount | 12382.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 93 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 796 |
| Total Drug Medicare AllowedAmount | 193.15 |
| Total Drug Medicare PaymentAmount | 162.45 |
| Total Drug Medicare Standardized Payment Amount | 162.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 318 |
| Number Of Medicare Beneficiaries With Medical Services | 104 |
| Total Medical Submitted Charge Amount | 22714.01 |
| Total Medical Medicare Allowed Amount | 14651.5 |
| Total Medical Medicare Payment Amount | 9340.99 |
| Total Medical Medicare Standardized Payment Amount | 12220.47 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 75 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | 78 |
| 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 | 56 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9204 |