| National Provider Identifier [NPI]: | 1508820648 |
| Last Name Of The Provider | ROSS |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 420 W ROWLAND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COVINA |
| Zip Code Of The Provider | 917232943 |
| 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 | 35 |
| Number Of Services | 217 |
| Number Of Medicare Beneficiaries | 105 |
| Total Submitted Charge Amount | 22651 |
| Total Medicare Allowed Amount | 13112.71 |
| Total Medicare Payment Amount | 8908.56 |
| Total Medicare Standardized Payment Amount | 9754.69 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 56 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 66 |
| 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 | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8624 |