| National Provider Identifier [NPI]: | 1467408690 |
| Last Name Of The Provider | RANDALL |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5301 E GRANT RD |
| Street Address 2 Of The Provider | ORTHOPAEDIC BLDG, 1ST FLOOR |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857122805 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1361 |
| Number Of Medicare Beneficiaries | 327 |
| Total Submitted Charge Amount | 325349.1 |
| Total Medicare Allowed Amount | 75840.37 |
| Total Medicare Payment Amount | 56040.24 |
| Total Medicare Standardized Payment Amount | 60377.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 476 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 40438 |
| Total Drug Medicare AllowedAmount | 16330.72 |
| Total Drug Medicare PaymentAmount | 12590.14 |
| Total Drug Medicare Standardized Payment Amount | 12590.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 885 |
| Number Of Medicare Beneficiaries With Medical Services | 327 |
| Total Medical Submitted Charge Amount | 284911.1 |
| Total Medical Medicare Allowed Amount | 59509.65 |
| Total Medical Medicare Payment Amount | 43450.1 |
| Total Medical Medicare Standardized Payment Amount | 47787.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 193 |
| Number Of Male Beneficiaries | 134 |
| Number Of Non Hispanic White Beneficiaries | 303 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.793 |