| National Provider Identifier [NPI]: | 1487969192 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1525 MADISON ST STE 2 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDONIA |
| Zip Code Of The Provider | 667361704 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 507 |
| Number Of Medicare Beneficiaries | 184 |
| Total Submitted Charge Amount | 48081.54 |
| Total Medicare Allowed Amount | 24821.55 |
| Total Medicare Payment Amount | 17571.82 |
| Total Medicare Standardized Payment Amount | 22287.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 98 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 2106 |
| Total Drug Medicare AllowedAmount | 61.03 |
| Total Drug Medicare PaymentAmount | 45.52 |
| Total Drug Medicare Standardized Payment Amount | 45.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 409 |
| Number Of Medicare Beneficiaries With Medical Services | 184 |
| Total Medical Submitted Charge Amount | 45975.54 |
| Total Medical Medicare Allowed Amount | 24760.52 |
| Total Medical Medicare Payment Amount | 17526.3 |
| Total Medical Medicare Standardized Payment Amount | 22242.01 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 73 |
| 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 | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1342 |