| National Provider Identifier [NPI]: | 1174783062 |
| Last Name Of The Provider | MCDANIEL |
| First Name Of The Provider | JACQUELINE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 35 S WEST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAYNESBURG |
| Zip Code Of The Provider | 153702029 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 263 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 16799 |
| Total Medicare Allowed Amount | 12114.24 |
| Total Medicare Payment Amount | 7870.99 |
| Total Medicare Standardized Payment Amount | 9779.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 963 |
| Total Drug Medicare AllowedAmount | 614.58 |
| Total Drug Medicare PaymentAmount | 599.91 |
| Total Drug Medicare Standardized Payment Amount | 599.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 232 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 15836 |
| Total Medical Medicare Allowed Amount | 11499.66 |
| Total Medical Medicare Payment Amount | 7271.08 |
| Total Medical Medicare Standardized Payment Amount | 9180.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 59 |
| 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 | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8496 |