| National Provider Identifier [NPI]: | 1285714113 |
| Last Name Of The Provider | TOERBER-CLARK |
| First Name Of The Provider | JODY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 CAISSON HILL ROAD |
| Street Address 2 Of The Provider | ATTN: MCXX-CLD-QM (CRED) |
| City Of The Provider | FORT RILEY |
| Zip Code Of The Provider | 664425037 |
| 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 | 49 |
| Number Of Services | 782 |
| Number Of Medicare Beneficiaries | 224 |
| Total Submitted Charge Amount | 44023.43 |
| Total Medicare Allowed Amount | 28268.84 |
| Total Medicare Payment Amount | 19628.91 |
| Total Medicare Standardized Payment Amount | 24453.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 272 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 4388.25 |
| Total Drug Medicare AllowedAmount | 2996.19 |
| Total Drug Medicare PaymentAmount | 2536.74 |
| Total Drug Medicare Standardized Payment Amount | 2536.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 510 |
| Number Of Medicare Beneficiaries With Medical Services | 224 |
| Total Medical Submitted Charge Amount | 39635.18 |
| Total Medical Medicare Allowed Amount | 25272.65 |
| Total Medical Medicare Payment Amount | 17092.17 |
| Total Medical Medicare Standardized Payment Amount | 21916.67 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 147 |
| Number Of Male Beneficiaries | 77 |
| 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 | 196 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0572 |