| National Provider Identifier [NPI]: | 1508980947 |
| Last Name Of The Provider | PERRY |
| First Name Of The Provider | CHAD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 308 COLISEUM DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312173876 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 5837 |
| Number Of Medicare Beneficiaries | 1101 |
| Total Submitted Charge Amount | 345812.58 |
| Total Medicare Allowed Amount | 271209.38 |
| Total Medicare Payment Amount | 191916.04 |
| Total Medicare Standardized Payment Amount | 239046.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 4051.63 |
| Total Drug Medicare AllowedAmount | 4051.63 |
| Total Drug Medicare PaymentAmount | 3032.32 |
| Total Drug Medicare Standardized Payment Amount | 3032.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 5809 |
| Number Of Medicare Beneficiaries With Medical Services | 1101 |
| Total Medical Submitted Charge Amount | 341760.95 |
| Total Medical Medicare Allowed Amount | 267157.75 |
| Total Medical Medicare Payment Amount | 188883.72 |
| Total Medical Medicare Standardized Payment Amount | 236014.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 546 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 565 |
| Number Of Non Hispanic White Beneficiaries | 1030 |
| Number Of Black or African American Beneficiaries | 52 |
| 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 | 1024 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0107 |