| National Provider Identifier [NPI]: | 1356433262 |
| Last Name Of The Provider | ROE |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3104 SUNSET BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKLIN |
| Zip Code Of The Provider | 95677 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 632 |
| Number Of Medicare Beneficiaries | 226 |
| Total Submitted Charge Amount | 49826 |
| Total Medicare Allowed Amount | 32527.05 |
| Total Medicare Payment Amount | 22379.91 |
| Total Medicare Standardized Payment Amount | 25608.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1330 |
| Total Drug Medicare AllowedAmount | 838.04 |
| Total Drug Medicare PaymentAmount | 815.38 |
| Total Drug Medicare Standardized Payment Amount | 815.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 597 |
| Number Of Medicare Beneficiaries With Medical Services | 226 |
| Total Medical Submitted Charge Amount | 48496 |
| Total Medical Medicare Allowed Amount | 31689.01 |
| Total Medical Medicare Payment Amount | 21564.53 |
| Total Medical Medicare Standardized Payment Amount | 24793.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 190 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0469 |