| National Provider Identifier [NPI]: | 1326088014 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16259 SYLVESTER RD SW |
| Street Address 2 Of The Provider | 303 |
| City Of The Provider | BURIEN |
| Zip Code Of The Provider | 981663049 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 2628 |
| Number Of Medicare Beneficiaries | 339 |
| Total Submitted Charge Amount | 443119.47 |
| Total Medicare Allowed Amount | 200011.91 |
| Total Medicare Payment Amount | 151663.68 |
| Total Medicare Standardized Payment Amount | 143233.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 812 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 32775 |
| Total Drug Medicare AllowedAmount | 20577.34 |
| Total Drug Medicare PaymentAmount | 16108.97 |
| Total Drug Medicare Standardized Payment Amount | 16108.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 1816 |
| Number Of Medicare Beneficiaries With Medical Services | 339 |
| Total Medical Submitted Charge Amount | 410344.47 |
| Total Medical Medicare Allowed Amount | 179434.57 |
| Total Medical Medicare Payment Amount | 135554.71 |
| Total Medical Medicare Standardized Payment Amount | 127124.44 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 147 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 302 |
| Number Of Black or African American Beneficiaries | 12 |
| 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 | 314 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1755 |