| National Provider Identifier [NPI]: | 1497056519 |
| Last Name Of The Provider | KISEL |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MPAS, PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 327 N WASHINGTON AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | SCRANTON |
| Zip Code Of The Provider | 185031549 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 3981 |
| Number Of Medicare Beneficiaries | 1015 |
| Total Submitted Charge Amount | 308933 |
| Total Medicare Allowed Amount | 170999.71 |
| Total Medicare Payment Amount | 121714.9 |
| Total Medicare Standardized Payment Amount | 150042.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 142 |
| Total Drug Medicare AllowedAmount | 119.51 |
| Total Drug Medicare PaymentAmount | 85.11 |
| Total Drug Medicare Standardized Payment Amount | 85.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 3914 |
| Number Of Medicare Beneficiaries With Medical Services | 1015 |
| Total Medical Submitted Charge Amount | 308791 |
| Total Medical Medicare Allowed Amount | 170880.2 |
| Total Medical Medicare Payment Amount | 121629.79 |
| Total Medical Medicare Standardized Payment Amount | 149957.54 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 452 |
| Number Of Beneficiaries Age 75 to 84 | 283 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 572 |
| Number Of Male Beneficiaries | 443 |
| Number Of Non Hispanic White Beneficiaries | 986 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 868 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0213 |