| National Provider Identifier [NPI]: | 1679516439 |
| Last Name Of The Provider | JAMES |
| First Name Of The Provider | KRISTINE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | PHYSICIAN ASSISTANT |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17904 GEORGIA AVENUE |
| Street Address 2 Of The Provider | SUITE 215 |
| City Of The Provider | OLNEY |
| Zip Code Of The Provider | 20832 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 307 |
| Number Of Medicare Beneficiaries | 80 |
| Total Submitted Charge Amount | 171756.5 |
| Total Medicare Allowed Amount | 17455.72 |
| Total Medicare Payment Amount | 13381.38 |
| Total Medicare Standardized Payment Amount | 13728.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 3525 |
| Total Drug Medicare AllowedAmount | 1061.46 |
| Total Drug Medicare PaymentAmount | 832.27 |
| Total Drug Medicare Standardized Payment Amount | 832.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 249 |
| Number Of Medicare Beneficiaries With Medical Services | 80 |
| Total Medical Submitted Charge Amount | 168231.5 |
| Total Medical Medicare Allowed Amount | 16394.26 |
| Total Medical Medicare Payment Amount | 12549.11 |
| Total Medical Medicare Standardized Payment Amount | 12896.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | 69 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7653 |