| National Provider Identifier [NPI]: | 1508834631 |
| Last Name Of The Provider | MATTHEWS |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5614 SAN JOSE BLVD |
| Street Address 2 Of The Provider | UFJP SAN JOSE FAMILY PRACTICE CENTER |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322077616 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 645 |
| Number Of Medicare Beneficiaries | 145 |
| Total Submitted Charge Amount | 88260 |
| Total Medicare Allowed Amount | 40172.16 |
| Total Medicare Payment Amount | 27428.63 |
| Total Medicare Standardized Payment Amount | 33166.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 943 |
| Total Drug Medicare AllowedAmount | 432.62 |
| Total Drug Medicare PaymentAmount | 423.98 |
| Total Drug Medicare Standardized Payment Amount | 423.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 620 |
| Number Of Medicare Beneficiaries With Medical Services | 145 |
| Total Medical Submitted Charge Amount | 87317 |
| Total Medical Medicare Allowed Amount | 39739.54 |
| Total Medical Medicare Payment Amount | 27004.65 |
| Total Medical Medicare Standardized Payment Amount | 32742.06 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 97 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 68 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1462 |