| National Provider Identifier [NPI]: | 1356455745 |
| Last Name Of The Provider | SHORT |
| First Name Of The Provider | DEAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 834 SHERIDAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT TOWNSEND |
| Zip Code Of The Provider | 983682443 |
| 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 | 60 |
| Number Of Services | 2621 |
| Number Of Medicare Beneficiaries | 380 |
| Total Submitted Charge Amount | 416558.51 |
| Total Medicare Allowed Amount | 128855.69 |
| Total Medicare Payment Amount | 95735.85 |
| Total Medicare Standardized Payment Amount | 110996.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 742 |
| Number Of Medicare Beneficiaries With Drug Services | 176 |
| Total Drug Submitted ChargeAmount | 139052.96 |
| Total Drug Medicare AllowedAmount | 34763.76 |
| Total Drug Medicare PaymentAmount | 26753.03 |
| Total Drug Medicare Standardized Payment Amount | 26753.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1879 |
| Number Of Medicare Beneficiaries With Medical Services | 380 |
| Total Medical Submitted Charge Amount | 277505.55 |
| Total Medical Medicare Allowed Amount | 94091.93 |
| Total Medical Medicare Payment Amount | 68982.82 |
| Total Medical Medicare Standardized Payment Amount | 84242.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 361 |
| 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 | 331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9202 |