| National Provider Identifier [NPI]: | 1760677629 |
| Last Name Of The Provider | ROSS |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C, ATC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3015 SQUALICUM PKWY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | BELLINGHAM |
| Zip Code Of The Provider | 982251945 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 909 |
| Number Of Medicare Beneficiaries | 234 |
| Total Submitted Charge Amount | 215040.71 |
| Total Medicare Allowed Amount | 56477.24 |
| Total Medicare Payment Amount | 42159.01 |
| Total Medicare Standardized Payment Amount | 44805.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 305 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 44677 |
| Total Drug Medicare AllowedAmount | 15141.41 |
| Total Drug Medicare PaymentAmount | 11604.76 |
| Total Drug Medicare Standardized Payment Amount | 11604.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 604 |
| Number Of Medicare Beneficiaries With Medical Services | 234 |
| Total Medical Submitted Charge Amount | 170363.71 |
| Total Medical Medicare Allowed Amount | 41335.83 |
| Total Medical Medicare Payment Amount | 30554.25 |
| Total Medical Medicare Standardized Payment Amount | 33200.65 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 220 |
| 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 | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.145 |