| National Provider Identifier [NPI]: | 1972555712 |
| Last Name Of The Provider | TUCKER |
| First Name Of The Provider | JODIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1965 S FREMONT AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658042201 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 839 |
| Number Of Medicare Beneficiaries | 587 |
| Total Submitted Charge Amount | 78375 |
| Total Medicare Allowed Amount | 37679.06 |
| Total Medicare Payment Amount | 27116.85 |
| Total Medicare Standardized Payment Amount | 34517.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 805 |
| Total Drug Medicare AllowedAmount | 494.63 |
| Total Drug Medicare PaymentAmount | 476.3 |
| Total Drug Medicare Standardized Payment Amount | 476.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 805 |
| Number Of Medicare Beneficiaries With Medical Services | 587 |
| Total Medical Submitted Charge Amount | 77570 |
| Total Medical Medicare Allowed Amount | 37184.43 |
| Total Medical Medicare Payment Amount | 26640.55 |
| Total Medical Medicare Standardized Payment Amount | 34041.19 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 234 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 347 |
| Number Of Male Beneficiaries | 240 |
| Number Of Non Hispanic White Beneficiaries | 568 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 470 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 117 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.173 |