| National Provider Identifier [NPI]: | 1679658678 |
| Last Name Of The Provider | VAN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20730 BOND RD NE STE 205 |
| Street Address 2 Of The Provider | |
| City Of The Provider | POULSBO |
| Zip Code Of The Provider | 983709000 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 1178 |
| Number Of Medicare Beneficiaries | 548 |
| Total Submitted Charge Amount | 113657.8 |
| Total Medicare Allowed Amount | 50851.28 |
| Total Medicare Payment Amount | 33163.52 |
| Total Medicare Standardized Payment Amount | 40378.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 804 |
| Total Drug Medicare AllowedAmount | 435.97 |
| Total Drug Medicare PaymentAmount | 318.61 |
| Total Drug Medicare Standardized Payment Amount | 318.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 1136 |
| Number Of Medicare Beneficiaries With Medical Services | 548 |
| Total Medical Submitted Charge Amount | 112853.8 |
| Total Medical Medicare Allowed Amount | 50415.31 |
| Total Medical Medicare Payment Amount | 32844.91 |
| Total Medical Medicare Standardized Payment Amount | 40059.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 291 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 319 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 506 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8861 |