| National Provider Identifier [NPI]: | 1083752893 |
| Last Name Of The Provider | SPANO |
| First Name Of The Provider | JACQUELINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 323 CROMWELL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKY HILL |
| Zip Code Of The Provider | 060671801 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 358 |
| Number Of Medicare Beneficiaries | 185 |
| Total Submitted Charge Amount | 9588.34 |
| Total Medicare Allowed Amount | 9318.51 |
| Total Medicare Payment Amount | 8654.56 |
| Total Medicare Standardized Payment Amount | 9447.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 167 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 4280.34 |
| Total Drug Medicare AllowedAmount | 4208.91 |
| Total Drug Medicare PaymentAmount | 4118.26 |
| Total Drug Medicare Standardized Payment Amount | 4118.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 191 |
| Number Of Medicare Beneficiaries With Medical Services | 185 |
| Total Medical Submitted Charge Amount | 5308 |
| Total Medical Medicare Allowed Amount | 5109.6 |
| Total Medical Medicare Payment Amount | 4536.3 |
| Total Medical Medicare Standardized Payment Amount | 5328.8 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 166 |
| 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 | 160 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8837 |