| National Provider Identifier [NPI]: | 1649492752 |
| Last Name Of The Provider | MCBEAN |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1305 POST RD |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | FAIRFIELD |
| Zip Code Of The Provider | 068246016 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1956 |
| Number Of Medicare Beneficiaries | 426 |
| Total Submitted Charge Amount | 178234.45 |
| Total Medicare Allowed Amount | 156633.74 |
| Total Medicare Payment Amount | 114384.63 |
| Total Medicare Standardized Payment Amount | 107875.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 5020 |
| Total Drug Medicare AllowedAmount | 4967.99 |
| Total Drug Medicare PaymentAmount | 3894.78 |
| Total Drug Medicare Standardized Payment Amount | 3894.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 1916 |
| Number Of Medicare Beneficiaries With Medical Services | 426 |
| Total Medical Submitted Charge Amount | 173214.45 |
| Total Medical Medicare Allowed Amount | 151665.75 |
| Total Medical Medicare Payment Amount | 110489.85 |
| Total Medical Medicare Standardized Payment Amount | 103981.17 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 216 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 396 |
| Number Of Black or African American Beneficiaries | |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 396 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9409 |