| National Provider Identifier [NPI]: | 1053587014 |
| Last Name Of The Provider | DELONG |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4092 FOXWOOD DR |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | VIRGINIA BEACH |
| Zip Code Of The Provider | 234625225 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 1086 |
| Number Of Medicare Beneficiaries | 647 |
| Total Submitted Charge Amount | 328258 |
| Total Medicare Allowed Amount | 102204.92 |
| Total Medicare Payment Amount | 78189.18 |
| Total Medicare Standardized Payment Amount | 79956.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1086 |
| Number Of Medicare Beneficiaries With Medical Services | 647 |
| Total Medical Submitted Charge Amount | 328258 |
| Total Medical Medicare Allowed Amount | 102204.92 |
| Total Medical Medicare Payment Amount | 78189.18 |
| Total Medical Medicare Standardized Payment Amount | 79956.45 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 181 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 380 |
| Number Of Male Beneficiaries | 267 |
| Number Of Non Hispanic White Beneficiaries | 359 |
| 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 | 430 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.0597 |