| National Provider Identifier [NPI]: | 1407007412 |
| Last Name Of The Provider | JONES |
| First Name Of The Provider | BRENNON |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3303 E BASELINE RD |
| Street Address 2 Of The Provider | SUITE 113 |
| City Of The Provider | GILBERT |
| Zip Code Of The Provider | 852342738 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 1559 |
| Number Of Medicare Beneficiaries | 23 |
| Total Submitted Charge Amount | 55569.75 |
| Total Medicare Allowed Amount | 39718.24 |
| Total Medicare Payment Amount | 29705.07 |
| Total Medicare Standardized Payment Amount | 35781.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 642 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 4518.75 |
| Total Drug Medicare AllowedAmount | 3137.63 |
| Total Drug Medicare PaymentAmount | 2386.24 |
| Total Drug Medicare Standardized Payment Amount | 2386.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 4 |
| Number Of Medical Services | 917 |
| Number Of Medicare Beneficiaries With Medical Services | 23 |
| Total Medical Submitted Charge Amount | 51051 |
| Total Medical Medicare Allowed Amount | 36580.61 |
| Total Medical Medicare Payment Amount | 27318.83 |
| Total Medical Medicare Standardized Payment Amount | 33395.57 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 12 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 0 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 0 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.6574 |