| National Provider Identifier [NPI]: | 1689879983 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | JAMESETTA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2815 AARONWOOD AVE. NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | MASSILLON |
| Zip Code Of The Provider | 44646 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2145 |
| Number Of Medicare Beneficiaries | 494 |
| Total Submitted Charge Amount | 651381 |
| Total Medicare Allowed Amount | 141117.37 |
| Total Medicare Payment Amount | 106638.69 |
| Total Medicare Standardized Payment Amount | 104749.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 94 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 2020 |
| Total Drug Medicare AllowedAmount | 398.09 |
| Total Drug Medicare PaymentAmount | 304.9 |
| Total Drug Medicare Standardized Payment Amount | 304.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 2051 |
| Number Of Medicare Beneficiaries With Medical Services | 494 |
| Total Medical Submitted Charge Amount | 649361 |
| Total Medical Medicare Allowed Amount | 140719.28 |
| Total Medical Medicare Payment Amount | 106333.79 |
| Total Medical Medicare Standardized Payment Amount | 104444.5 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 288 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 306 |
| Number Of Male Beneficiaries | 188 |
| Number Of Non Hispanic White Beneficiaries | 446 |
| Number Of Black or African American Beneficiaries | 35 |
| 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 | 244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 250 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6332 |