| National Provider Identifier [NPI]: | 1942260567 |
| Last Name Of The Provider | BLAU |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1814 ROSELAND BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757014262 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 7279 |
| Number Of Medicare Beneficiaries | 890 |
| Total Submitted Charge Amount | 1454805.16 |
| Total Medicare Allowed Amount | 387745.81 |
| Total Medicare Payment Amount | 296676.74 |
| Total Medicare Standardized Payment Amount | 286204.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2020 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 35881 |
| Total Drug Medicare AllowedAmount | 21068.51 |
| Total Drug Medicare PaymentAmount | 16394.85 |
| Total Drug Medicare Standardized Payment Amount | 16394.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 5259 |
| Number Of Medicare Beneficiaries With Medical Services | 890 |
| Total Medical Submitted Charge Amount | 1418924.16 |
| Total Medical Medicare Allowed Amount | 366677.3 |
| Total Medical Medicare Payment Amount | 280281.89 |
| Total Medical Medicare Standardized Payment Amount | 269809.35 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 360 |
| Number Of Beneficiaries Age 65 to 74 | 319 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 553 |
| Number Of Male Beneficiaries | 337 |
| Number Of Non Hispanic White Beneficiaries | 726 |
| Number Of Black or African American Beneficiaries | 132 |
| 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 | 654 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 236 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4236 |