| National Provider Identifier [NPI]: | 1427485960 |
| Last Name Of The Provider | PAGE |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MSN, RN, AGNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | DUMC 3921 |
| Street Address 2 Of The Provider | 201 TRENT DRIVE |
| City Of The Provider | DURHAM |
| Zip Code Of The Provider | 277100001 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 104 |
| Number Of Medicare Beneficiaries | 42 |
| Total Submitted Charge Amount | 15057.5 |
| Total Medicare Allowed Amount | 5801.72 |
| Total Medicare Payment Amount | 4613.87 |
| Total Medicare Standardized Payment Amount | 5707.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 525 |
| Total Drug Medicare AllowedAmount | 211.5 |
| Total Drug Medicare PaymentAmount | 207.3 |
| Total Drug Medicare Standardized Payment Amount | 207.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 89 |
| Number Of Medicare Beneficiaries With Medical Services | 38 |
| Total Medical Submitted Charge Amount | 14532.5 |
| Total Medical Medicare Allowed Amount | 5590.22 |
| Total Medical Medicare Payment Amount | 4406.57 |
| Total Medical Medicare Standardized Payment Amount | 5499.76 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | 11 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 19 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | 21 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 22 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| 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 | 50 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.5014 |