| National Provider Identifier [NPI]: | 1497883789 |
| Last Name Of The Provider | HAMBLIN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | P.A.-C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1807 W UNIVERSITY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DURANT |
| Zip Code Of The Provider | 747013011 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 2713 |
| Number Of Medicare Beneficiaries | 810 |
| Total Submitted Charge Amount | 164728 |
| Total Medicare Allowed Amount | 112433.85 |
| Total Medicare Payment Amount | 72594.17 |
| Total Medicare Standardized Payment Amount | 98909.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 665 |
| Number Of Medicare Beneficiaries With Drug Services | 412 |
| Total Drug Submitted ChargeAmount | 15825 |
| Total Drug Medicare AllowedAmount | 3570.94 |
| Total Drug Medicare PaymentAmount | 2535.66 |
| Total Drug Medicare Standardized Payment Amount | 2535.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 2048 |
| Number Of Medicare Beneficiaries With Medical Services | 810 |
| Total Medical Submitted Charge Amount | 148903 |
| Total Medical Medicare Allowed Amount | 108862.91 |
| Total Medical Medicare Payment Amount | 70058.51 |
| Total Medical Medicare Standardized Payment Amount | 96374.02 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 435 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 455 |
| Number Of Male Beneficiaries | 355 |
| Number Of Non Hispanic White Beneficiaries | 732 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 63 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 752 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9496 |