| National Provider Identifier [NPI]: | 1831279561 |
| Last Name Of The Provider | BAIN |
| First Name Of The Provider | JULIE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5350 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINSTON SALEM |
| Zip Code Of The Provider | 271079174 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 424 |
| Number Of Medicare Beneficiaries | 106 |
| Total Submitted Charge Amount | 32169 |
| Total Medicare Allowed Amount | 16974.96 |
| Total Medicare Payment Amount | 11738.11 |
| Total Medicare Standardized Payment Amount | 14994.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 984 |
| Total Drug Medicare AllowedAmount | 418.65 |
| Total Drug Medicare PaymentAmount | 394.58 |
| Total Drug Medicare Standardized Payment Amount | 394.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 380 |
| Number Of Medicare Beneficiaries With Medical Services | 106 |
| Total Medical Submitted Charge Amount | 31185 |
| Total Medical Medicare Allowed Amount | 16556.31 |
| Total Medical Medicare Payment Amount | 11343.53 |
| Total Medical Medicare Standardized Payment Amount | 14599.55 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.007 |