| National Provider Identifier [NPI]: | 1831196096 |
| Last Name Of The Provider | NICKENS |
| First Name Of The Provider | JONI |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4560 NORTH BLVD |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708064043 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 376 |
| Number Of Medicare Beneficiaries | 87 |
| Total Submitted Charge Amount | 40353 |
| Total Medicare Allowed Amount | 20840.46 |
| Total Medicare Payment Amount | 13957.07 |
| Total Medicare Standardized Payment Amount | 17362.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 88 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 4645 |
| Total Drug Medicare AllowedAmount | 2708.1 |
| Total Drug Medicare PaymentAmount | 2631.62 |
| Total Drug Medicare Standardized Payment Amount | 2631.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 288 |
| Number Of Medicare Beneficiaries With Medical Services | 87 |
| Total Medical Submitted Charge Amount | 35708 |
| Total Medical Medicare Allowed Amount | 18132.36 |
| Total Medical Medicare Payment Amount | 11325.45 |
| Total Medical Medicare Standardized Payment Amount | 14730.64 |
| Average Age Of Beneficiaries | 50 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 56 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7521 |