| National Provider Identifier [NPI]: | 1457349557 |
| Last Name Of The Provider | HOOVER |
| First Name Of The Provider | JANE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | RN MSN FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1207 MICHIGAN STREET |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | SANDPOINT |
| Zip Code Of The Provider | 83864 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 443 |
| Number Of Medicare Beneficiaries | 174 |
| Total Submitted Charge Amount | 53299 |
| Total Medicare Allowed Amount | 24792.88 |
| Total Medicare Payment Amount | 15871.7 |
| Total Medicare Standardized Payment Amount | 21189.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 868 |
| Total Drug Medicare AllowedAmount | 711.87 |
| Total Drug Medicare PaymentAmount | 695.5 |
| Total Drug Medicare Standardized Payment Amount | 695.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 409 |
| Number Of Medicare Beneficiaries With Medical Services | 174 |
| Total Medical Submitted Charge Amount | 52431 |
| Total Medical Medicare Allowed Amount | 24081.01 |
| Total Medical Medicare Payment Amount | 15176.2 |
| Total Medical Medicare Standardized Payment Amount | 20493.83 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 51 |
| 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 | 140 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7911 |