| National Provider Identifier [NPI]: | 1124307186 |
| Last Name Of The Provider | JARAMILLO |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12262 E BRADSHAW MOUNTAIN RD |
| Street Address 2 Of The Provider | #2 |
| City Of The Provider | DEWEY |
| Zip Code Of The Provider | 863276032 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 694 |
| Number Of Medicare Beneficiaries | 153 |
| Total Submitted Charge Amount | 70258.85 |
| Total Medicare Allowed Amount | 51489.89 |
| Total Medicare Payment Amount | 38767.76 |
| Total Medicare Standardized Payment Amount | 46101.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 689 |
| Total Drug Medicare AllowedAmount | 122.45 |
| Total Drug Medicare PaymentAmount | 115.29 |
| Total Drug Medicare Standardized Payment Amount | 115.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 663 |
| Number Of Medicare Beneficiaries With Medical Services | 153 |
| Total Medical Submitted Charge Amount | 69569.85 |
| Total Medical Medicare Allowed Amount | 51367.44 |
| Total Medical Medicare Payment Amount | 38652.47 |
| Total Medical Medicare Standardized Payment Amount | 45986.55 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 65 |
| 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 | 109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| 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 | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8412 |