| National Provider Identifier [NPI]: | 1265681522 |
| Last Name Of The Provider | MANRESA |
| First Name Of The Provider | ASHLEY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 740 W PLYMOUTH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DELAND |
| Zip Code Of The Provider | 327203282 |
| 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 | 47 |
| Number Of Services | 349 |
| Number Of Medicare Beneficiaries | 184 |
| Total Submitted Charge Amount | 271263.39 |
| Total Medicare Allowed Amount | 31470.09 |
| Total Medicare Payment Amount | 24212.23 |
| Total Medicare Standardized Payment Amount | 25155.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 89 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 8103.4 |
| Total Drug Medicare AllowedAmount | 4297.86 |
| Total Drug Medicare PaymentAmount | 3368.22 |
| Total Drug Medicare Standardized Payment Amount | 3368.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 260 |
| Number Of Medicare Beneficiaries With Medical Services | 184 |
| Total Medical Submitted Charge Amount | 263159.99 |
| Total Medical Medicare Allowed Amount | 27172.23 |
| Total Medical Medicare Payment Amount | 20844.01 |
| Total Medical Medicare Standardized Payment Amount | 21786.87 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 160 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6106 |