| National Provider Identifier [NPI]: | 1174952139 |
| Last Name Of The Provider | FACCIA |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | AGACNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1345 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRANKLIN |
| Zip Code Of The Provider | 370643703 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2126 |
| Number Of Medicare Beneficiaries | 213 |
| Total Submitted Charge Amount | 185365 |
| Total Medicare Allowed Amount | 81505.7 |
| Total Medicare Payment Amount | 69644.68 |
| Total Medicare Standardized Payment Amount | 78609.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 267 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 8130 |
| Total Drug Medicare AllowedAmount | 1238.89 |
| Total Drug Medicare PaymentAmount | 971.32 |
| Total Drug Medicare Standardized Payment Amount | 971.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1859 |
| Number Of Medicare Beneficiaries With Medical Services | 213 |
| Total Medical Submitted Charge Amount | 177235 |
| Total Medical Medicare Allowed Amount | 80266.81 |
| Total Medical Medicare Payment Amount | 68673.36 |
| Total Medical Medicare Standardized Payment Amount | 77638.34 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 134 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 16 |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 194 |
| 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 | 94 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.469 |