| National Provider Identifier [NPI]: | 1083963862 |
| Last Name Of The Provider | STEFANIC |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2501 N 3RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRISBURG |
| Zip Code Of The Provider | 171101904 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 155 |
| Number Of Medicare Beneficiaries | 64 |
| Total Submitted Charge Amount | 18445 |
| Total Medicare Allowed Amount | 7911.67 |
| Total Medicare Payment Amount | 5292.72 |
| Total Medicare Standardized Payment Amount | 6617.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 265 |
| Total Drug Medicare AllowedAmount | 175 |
| Total Drug Medicare PaymentAmount | 169.77 |
| Total Drug Medicare Standardized Payment Amount | 169.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 139 |
| Number Of Medicare Beneficiaries With Medical Services | 64 |
| Total Medical Submitted Charge Amount | 18180 |
| Total Medical Medicare Allowed Amount | 7736.67 |
| Total Medical Medicare Payment Amount | 5122.95 |
| Total Medical Medicare Standardized Payment Amount | 6447.26 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 38 |
| Number Of Male Beneficiaries | 26 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 40 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2728 |