| National Provider Identifier [NPI]: | 1487815148 |
| Last Name Of The Provider | PAGE |
| First Name Of The Provider | JACOB |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | A.C.N.P. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 510 RECOVERY RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | NASHVILLE |
| Zip Code Of The Provider | 372114874 |
| 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 | 31 |
| Number Of Services | 489 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 36673 |
| Total Medicare Allowed Amount | 18810.87 |
| Total Medicare Payment Amount | 14540.23 |
| Total Medicare Standardized Payment Amount | 18124.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 137 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 4450 |
| Total Drug Medicare AllowedAmount | 1183.03 |
| Total Drug Medicare PaymentAmount | 1015.84 |
| Total Drug Medicare Standardized Payment Amount | 1015.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 352 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 32223 |
| Total Medical Medicare Allowed Amount | 17627.84 |
| Total Medical Medicare Payment Amount | 13524.39 |
| Total Medical Medicare Standardized Payment Amount | 17109.04 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 85 |
| 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 | 87 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0755 |