| National Provider Identifier [NPI]: | 1588657985 |
| Last Name Of The Provider | EBERLY |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 325 BLUE VALLEY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BANGOR |
| Zip Code Of The Provider | 180131526 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2953 |
| Number Of Medicare Beneficiaries | 557 |
| Total Submitted Charge Amount | 223398 |
| Total Medicare Allowed Amount | 112351.39 |
| Total Medicare Payment Amount | 75517.14 |
| Total Medicare Standardized Payment Amount | 82454.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 128 |
| Total Drug Medicare AllowedAmount | 30.71 |
| Total Drug Medicare PaymentAmount | 24.09 |
| Total Drug Medicare Standardized Payment Amount | 24.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 2921 |
| Number Of Medicare Beneficiaries With Medical Services | 557 |
| Total Medical Submitted Charge Amount | 223270 |
| Total Medical Medicare Allowed Amount | 112320.68 |
| Total Medical Medicare Payment Amount | 75493.05 |
| Total Medical Medicare Standardized Payment Amount | 82430.66 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 186 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 230 |
| Number Of Non Hispanic White Beneficiaries | 532 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 508 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5018 |