| National Provider Identifier [NPI]: | 1417115247 |
| Last Name Of The Provider | MILK |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ERIE |
| Zip Code Of The Provider | 165500002 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1135 |
| Number Of Medicare Beneficiaries | 1015 |
| Total Submitted Charge Amount | 1067276 |
| Total Medicare Allowed Amount | 170449.45 |
| Total Medicare Payment Amount | 131722.08 |
| Total Medicare Standardized Payment Amount | 132770.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1135 |
| Number Of Medicare Beneficiaries With Medical Services | 1015 |
| Total Medical Submitted Charge Amount | 1067276 |
| Total Medical Medicare Allowed Amount | 170449.45 |
| Total Medical Medicare Payment Amount | 131722.08 |
| Total Medical Medicare Standardized Payment Amount | 132770.22 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 268 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 322 |
| Number Of Female Beneficiaries | 609 |
| Number Of Male Beneficiaries | 406 |
| Number Of Non Hispanic White Beneficiaries | 842 |
| Number Of Black or African American Beneficiaries | 140 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 776 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 239 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0078 |