| National Provider Identifier [NPI]: | 1366419707 |
| Last Name Of The Provider | NESBIT |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7061 GRAND MONTECITO PKWY |
| Street Address 2 Of The Provider | SOUTHWEST MEDICAL ASSOCIATES |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891490287 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 315 |
| Number Of Medicare Beneficiaries | 111 |
| Total Submitted Charge Amount | 27905 |
| Total Medicare Allowed Amount | 10615.6 |
| Total Medicare Payment Amount | 6974.1 |
| Total Medicare Standardized Payment Amount | 8401.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 115 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 595 |
| Total Drug Medicare AllowedAmount | 134.46 |
| Total Drug Medicare PaymentAmount | 92.43 |
| Total Drug Medicare Standardized Payment Amount | 92.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 200 |
| Number Of Medicare Beneficiaries With Medical Services | 111 |
| Total Medical Submitted Charge Amount | 27310 |
| Total Medical Medicare Allowed Amount | 10481.14 |
| Total Medical Medicare Payment Amount | 6881.67 |
| Total Medical Medicare Standardized Payment Amount | 8309.49 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | 81 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 93 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1927 |