| National Provider Identifier [NPI]: | 1023002623 |
| Last Name Of The Provider | HARE |
| First Name Of The Provider | JOAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MSN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1238 PUTTY HILL AVE |
| Street Address 2 Of The Provider | STE 6 |
| City Of The Provider | TOWSON |
| Zip Code Of The Provider | 212865844 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 448 |
| Number Of Medicare Beneficiaries | 228 |
| Total Submitted Charge Amount | 14008.2 |
| Total Medicare Allowed Amount | 12420.16 |
| Total Medicare Payment Amount | 11031.15 |
| Total Medicare Standardized Payment Amount | 13558.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 194 |
| Number Of Medicare Beneficiaries With Drug Services | 189 |
| Total Drug Submitted ChargeAmount | 7541.21 |
| Total Drug Medicare AllowedAmount | 6305.44 |
| Total Drug Medicare PaymentAmount | 6150.72 |
| Total Drug Medicare Standardized Payment Amount | 6150.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 254 |
| Number Of Medicare Beneficiaries With Medical Services | 226 |
| Total Medical Submitted Charge Amount | 6466.99 |
| Total Medical Medicare Allowed Amount | 6114.72 |
| Total Medical Medicare Payment Amount | 4880.43 |
| Total Medical Medicare Standardized Payment Amount | 7408.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 91 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7027 |