| National Provider Identifier [NPI]: | 1467640961 |
| Last Name Of The Provider | CONKLIN |
| First Name Of The Provider | JAMIE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 NE NEFF RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977016015 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1358 |
| Number Of Medicare Beneficiaries | 481 |
| Total Submitted Charge Amount | 323526.66 |
| Total Medicare Allowed Amount | 105530.34 |
| Total Medicare Payment Amount | 77488.48 |
| Total Medicare Standardized Payment Amount | 80720.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 2235 |
| Total Drug Medicare AllowedAmount | 1387.15 |
| Total Drug Medicare PaymentAmount | 1358.79 |
| Total Drug Medicare Standardized Payment Amount | 1358.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1306 |
| Number Of Medicare Beneficiaries With Medical Services | 481 |
| Total Medical Submitted Charge Amount | 321291.66 |
| Total Medical Medicare Allowed Amount | 104143.19 |
| Total Medical Medicare Payment Amount | 76129.69 |
| Total Medical Medicare Standardized Payment Amount | 79361.75 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 222 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 246 |
| Number Of Non Hispanic White Beneficiaries | 455 |
| 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 | 400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 53 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3679 |