| National Provider Identifier [NPI]: | 1255598181 |
| Last Name Of The Provider | ESHENAUR |
| First Name Of The Provider | RAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C, ATC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3373 COMMERCE PKWY |
| Street Address 2 Of The Provider | 2 |
| City Of The Provider | WOOSTER |
| Zip Code Of The Provider | 446917130 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 309 |
| Number Of Medicare Beneficiaries | 108 |
| Total Submitted Charge Amount | 96570 |
| Total Medicare Allowed Amount | 20336.14 |
| Total Medicare Payment Amount | 15464.96 |
| Total Medicare Standardized Payment Amount | 17526.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 5715 |
| Total Drug Medicare AllowedAmount | 4509.07 |
| Total Drug Medicare PaymentAmount | 3535.12 |
| Total Drug Medicare Standardized Payment Amount | 3535.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 252 |
| Number Of Medicare Beneficiaries With Medical Services | 108 |
| Total Medical Submitted Charge Amount | 90855 |
| Total Medical Medicare Allowed Amount | 15827.07 |
| Total Medical Medicare Payment Amount | 11929.84 |
| Total Medical Medicare Standardized Payment Amount | 13991.72 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 65 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 97 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.192 |