| National Provider Identifier [NPI]: | 1326125485 |
| Last Name Of The Provider | BLAZZARD |
| First Name Of The Provider | JACOB |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1205 SE PROFESSIONAL MALL BLVD |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | PULLMAN |
| Zip Code Of The Provider | 991635423 |
| 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 | 37 |
| Number Of Services | 3264 |
| Number Of Medicare Beneficiaries | 941 |
| Total Submitted Charge Amount | 246445 |
| Total Medicare Allowed Amount | 115296.06 |
| Total Medicare Payment Amount | 72248.58 |
| Total Medicare Standardized Payment Amount | 85598.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 3264 |
| Number Of Medicare Beneficiaries With Medical Services | 941 |
| Total Medical Submitted Charge Amount | 246445 |
| Total Medical Medicare Allowed Amount | 115296.06 |
| Total Medical Medicare Payment Amount | 72248.58 |
| Total Medical Medicare Standardized Payment Amount | 85598.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 419 |
| Number Of Beneficiaries Age 75 to 84 | 329 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 389 |
| Number Of Male Beneficiaries | 552 |
| Number Of Non Hispanic White Beneficiaries | 909 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 870 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9312 |