| National Provider Identifier [NPI]: | 1457322703 |
| Last Name Of The Provider | JENSEN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 202 CROSS ST SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUBURN |
| Zip Code Of The Provider | 980025406 |
| 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 | 80 |
| Number Of Services | 885 |
| Number Of Medicare Beneficiaries | 235 |
| Total Submitted Charge Amount | 86981 |
| Total Medicare Allowed Amount | 34786.22 |
| Total Medicare Payment Amount | 24983.17 |
| Total Medicare Standardized Payment Amount | 29800.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1842 |
| Total Drug Medicare AllowedAmount | 1334.03 |
| Total Drug Medicare PaymentAmount | 1084.93 |
| Total Drug Medicare Standardized Payment Amount | 1084.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 789 |
| Number Of Medicare Beneficiaries With Medical Services | 235 |
| Total Medical Submitted Charge Amount | 85139 |
| Total Medical Medicare Allowed Amount | 33452.19 |
| Total Medical Medicare Payment Amount | 23898.24 |
| Total Medical Medicare Standardized Payment Amount | 28715.54 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 127 |
| Number Of Non Hispanic White Beneficiaries | 224 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 224 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9658 |