| National Provider Identifier [NPI]: | 1699836791 |
| Last Name Of The Provider | RIVERA |
| First Name Of The Provider | YURI |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 WEEMS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PURVIS |
| Zip Code Of The Provider | 394754062 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 394 |
| Number Of Medicare Beneficiaries | 207 |
| Total Submitted Charge Amount | 55007 |
| Total Medicare Allowed Amount | 8307.28 |
| Total Medicare Payment Amount | 6335.38 |
| Total Medicare Standardized Payment Amount | 7841.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 554 |
| Total Drug Medicare AllowedAmount | 241.98 |
| Total Drug Medicare PaymentAmount | 195.97 |
| Total Drug Medicare Standardized Payment Amount | 195.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 368 |
| Number Of Medicare Beneficiaries With Medical Services | 207 |
| Total Medical Submitted Charge Amount | 54453 |
| Total Medical Medicare Allowed Amount | 8065.3 |
| Total Medical Medicare Payment Amount | 6139.41 |
| Total Medical Medicare Standardized Payment Amount | 7645.53 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | 179 |
| 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 | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1407 |