| National Provider Identifier [NPI]: | 1902886849 |
| Last Name Of The Provider | PIERCE |
| First Name Of The Provider | JANA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3633 BUNKER LAKE BLVD NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANDOVER |
| Zip Code Of The Provider | 553047402 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 384 |
| Number Of Medicare Beneficiaries | 98 |
| Total Submitted Charge Amount | 38014 |
| Total Medicare Allowed Amount | 14882.19 |
| Total Medicare Payment Amount | 10113.54 |
| Total Medicare Standardized Payment Amount | 12191.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 494 |
| Total Drug Medicare AllowedAmount | 335.13 |
| Total Drug Medicare PaymentAmount | 315.75 |
| Total Drug Medicare Standardized Payment Amount | 315.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 360 |
| Number Of Medicare Beneficiaries With Medical Services | 98 |
| Total Medical Submitted Charge Amount | 37520 |
| Total Medical Medicare Allowed Amount | 14547.06 |
| Total Medical Medicare Payment Amount | 9797.79 |
| Total Medical Medicare Standardized Payment Amount | 11876.22 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 66 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.0002 |