| National Provider Identifier [NPI]: | 1134138779 |
| Last Name Of The Provider | BOERGER |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | FNP APNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8348 WASHINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RACINE |
| Zip Code Of The Provider | 534063733 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 416 |
| Number Of Medicare Beneficiaries | 156 |
| Total Submitted Charge Amount | 75377.95 |
| Total Medicare Allowed Amount | 21292.65 |
| Total Medicare Payment Amount | 16250.72 |
| Total Medicare Standardized Payment Amount | 19875.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 790.95 |
| Total Drug Medicare AllowedAmount | 381.31 |
| Total Drug Medicare PaymentAmount | 369.7 |
| Total Drug Medicare Standardized Payment Amount | 369.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 389 |
| Number Of Medicare Beneficiaries With Medical Services | 156 |
| Total Medical Submitted Charge Amount | 74587 |
| Total Medical Medicare Allowed Amount | 20911.34 |
| Total Medical Medicare Payment Amount | 15881.02 |
| Total Medical Medicare Standardized Payment Amount | 19505.59 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 135 |
| 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 | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0928 |