| National Provider Identifier [NPI]: | 1073709622 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | JEREMIAH |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12289 HANCOCK ST |
| Street Address 2 Of The Provider | STE 34 |
| City Of The Provider | CARMEL |
| Zip Code Of The Provider | 460325801 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 543 |
| Number Of Medicare Beneficiaries | 399 |
| Total Submitted Charge Amount | 90243 |
| Total Medicare Allowed Amount | 32791.06 |
| Total Medicare Payment Amount | 23683.47 |
| Total Medicare Standardized Payment Amount | 30622.26 |
| 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 | 17 |
| Number Of Medical Services | 543 |
| Number Of Medicare Beneficiaries With Medical Services | 399 |
| Total Medical Submitted Charge Amount | 90243 |
| Total Medical Medicare Allowed Amount | 32791.06 |
| Total Medical Medicare Payment Amount | 23683.47 |
| Total Medical Medicare Standardized Payment Amount | 30622.26 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 183 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 199 |
| Number Of Non Hispanic White Beneficiaries | 337 |
| Number Of Black or African American Beneficiaries | |
| 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 | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1791 |