| National Provider Identifier [NPI]: | 1215997069 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1701 N STOCKTON HILL RD |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | KINGMAN |
| Zip Code Of The Provider | 864016600 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 3281 |
| Number Of Medicare Beneficiaries | 847 |
| Total Submitted Charge Amount | 271120 |
| Total Medicare Allowed Amount | 192222.37 |
| Total Medicare Payment Amount | 134642.78 |
| Total Medicare Standardized Payment Amount | 141061.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 389 |
| Total Drug Medicare AllowedAmount | 187.89 |
| Total Drug Medicare PaymentAmount | 131.32 |
| Total Drug Medicare Standardized Payment Amount | 131.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 3164 |
| Number Of Medicare Beneficiaries With Medical Services | 847 |
| Total Medical Submitted Charge Amount | 270731 |
| Total Medical Medicare Allowed Amount | 192034.48 |
| Total Medical Medicare Payment Amount | 134511.46 |
| Total Medical Medicare Standardized Payment Amount | 140929.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 288 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 468 |
| Number Of Male Beneficiaries | 379 |
| Number Of Non Hispanic White Beneficiaries | 796 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 781 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5371 |