| National Provider Identifier [NPI]: | 1649233396 |
| Last Name Of The Provider | BERNSTEIN |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4136 N 75TH AVE |
| Street Address 2 Of The Provider | #116 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850333100 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 763 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 84839.46 |
| Total Medicare Allowed Amount | 65967.94 |
| Total Medicare Payment Amount | 49770.6 |
| Total Medicare Standardized Payment Amount | 50800.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 182 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 8281.94 |
| Total Drug Medicare AllowedAmount | 5185.42 |
| Total Drug Medicare PaymentAmount | 4099.95 |
| Total Drug Medicare Standardized Payment Amount | 4099.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 581 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 76557.52 |
| Total Medical Medicare Allowed Amount | 60782.52 |
| Total Medical Medicare Payment Amount | 45670.65 |
| Total Medical Medicare Standardized Payment Amount | 46700.99 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 86 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5716 |