| National Provider Identifier [NPI]: | 1285888768 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | JENNY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7003 WOODWAY DR |
| Street Address 2 Of The Provider | SUITE 311 |
| City Of The Provider | WACO |
| Zip Code Of The Provider | 767126170 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 446 |
| Number Of Medicare Beneficiaries | 161 |
| Total Submitted Charge Amount | 31758 |
| Total Medicare Allowed Amount | 16120.07 |
| Total Medicare Payment Amount | 12122.09 |
| Total Medicare Standardized Payment Amount | 15256.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 125 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 935 |
| Total Drug Medicare AllowedAmount | 205.21 |
| Total Drug Medicare PaymentAmount | 154.32 |
| Total Drug Medicare Standardized Payment Amount | 154.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 321 |
| Number Of Medicare Beneficiaries With Medical Services | 161 |
| Total Medical Submitted Charge Amount | 30823 |
| Total Medical Medicare Allowed Amount | 15914.86 |
| Total Medical Medicare Payment Amount | 11967.77 |
| Total Medical Medicare Standardized Payment Amount | 15102.43 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 128 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 137 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 0.8998 |