| National Provider Identifier [NPI]: | 1760587174 |
| Last Name Of The Provider | JOLLY |
| First Name Of The Provider | JENNA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 101 DBA HOLYOKE ASSOCIATES IN INTERNAL MEDICINE |
| City Of The Provider | HOLYOKE |
| Zip Code Of The Provider | 01040 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1065 |
| Number Of Medicare Beneficiaries | 208 |
| Total Submitted Charge Amount | 122284 |
| Total Medicare Allowed Amount | 55615.47 |
| Total Medicare Payment Amount | 41903.48 |
| Total Medicare Standardized Payment Amount | 47963.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 3194 |
| Total Drug Medicare AllowedAmount | 2600.02 |
| Total Drug Medicare PaymentAmount | 2512.3 |
| Total Drug Medicare Standardized Payment Amount | 2512.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 983 |
| Number Of Medicare Beneficiaries With Medical Services | 208 |
| Total Medical Submitted Charge Amount | 119090 |
| Total Medical Medicare Allowed Amount | 53015.45 |
| Total Medical Medicare Payment Amount | 39391.18 |
| Total Medical Medicare Standardized Payment Amount | 45451.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 150 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| 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 | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0086 |