| National Provider Identifier [NPI]: | 1649553587 |
| Last Name Of The Provider | HAGE |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4200 N ARMENIA AVE |
| Street Address 2 Of The Provider | SUITE 1-2 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336076438 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2237 |
| Number Of Medicare Beneficiaries | 800 |
| Total Submitted Charge Amount | 254635.45 |
| Total Medicare Allowed Amount | 128032.59 |
| Total Medicare Payment Amount | 91231.15 |
| Total Medicare Standardized Payment Amount | 107544.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 2237 |
| Number Of Medicare Beneficiaries With Medical Services | 800 |
| Total Medical Submitted Charge Amount | 254635.45 |
| Total Medical Medicare Allowed Amount | 128032.59 |
| Total Medical Medicare Payment Amount | 91231.15 |
| Total Medical Medicare Standardized Payment Amount | 107544.5 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 412 |
| Number Of Female Beneficiaries | 556 |
| Number Of Male Beneficiaries | 244 |
| Number Of Non Hispanic White Beneficiaries | 713 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 522 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 278 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.75 |