| National Provider Identifier [NPI]: | 1730445891 |
| Last Name Of The Provider | MEREDITH |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 36491 YAMAS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILDOMAR |
| Zip Code Of The Provider | 925959809 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 533 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 162307 |
| Total Medicare Allowed Amount | 47107.8 |
| Total Medicare Payment Amount | 36933.34 |
| Total Medicare Standardized Payment Amount | 41502.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 533 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 162307 |
| Total Medical Medicare Allowed Amount | 47107.8 |
| Total Medical Medicare Payment Amount | 36933.34 |
| Total Medical Medicare Standardized Payment Amount | 41502.48 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 116 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 156 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 142 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.1962 |