| National Provider Identifier [NPI]: | 1265593685 |
| Last Name Of The Provider | UMLOR |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6100 NEWPORT RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | PORTAGE |
| Zip Code Of The Provider | 490029235 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 3231 |
| Number Of Medicare Beneficiaries | 645 |
| Total Submitted Charge Amount | 220013 |
| Total Medicare Allowed Amount | 131822.17 |
| Total Medicare Payment Amount | 92009.11 |
| Total Medicare Standardized Payment Amount | 114121.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 233 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 5701 |
| Total Drug Medicare AllowedAmount | 4735.55 |
| Total Drug Medicare PaymentAmount | 3597.02 |
| Total Drug Medicare Standardized Payment Amount | 3597.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2998 |
| Number Of Medicare Beneficiaries With Medical Services | 645 |
| Total Medical Submitted Charge Amount | 214312 |
| Total Medical Medicare Allowed Amount | 127086.62 |
| Total Medical Medicare Payment Amount | 88412.09 |
| Total Medical Medicare Standardized Payment Amount | 110524.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 307 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 366 |
| Number Of Male Beneficiaries | 279 |
| Number Of Non Hispanic White Beneficiaries | 594 |
| Number Of Black or African American Beneficiaries | 21 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 587 |
| 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 | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9052 |