| National Provider Identifier [NPI]: | 1780634469 |
| Last Name Of The Provider | JETT |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6 SHERIDAN SQ STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | KINGSPORT |
| Zip Code Of The Provider | 376607390 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 2665 |
| Number Of Medicare Beneficiaries | 361 |
| Total Submitted Charge Amount | 617282 |
| Total Medicare Allowed Amount | 183293.82 |
| Total Medicare Payment Amount | 135411.5 |
| Total Medicare Standardized Payment Amount | 134994.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1347 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 29148 |
| Total Drug Medicare AllowedAmount | 8111.4 |
| Total Drug Medicare PaymentAmount | 3710.77 |
| Total Drug Medicare Standardized Payment Amount | 3710.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1318 |
| Number Of Medicare Beneficiaries With Medical Services | 361 |
| Total Medical Submitted Charge Amount | 588134 |
| Total Medical Medicare Allowed Amount | 175182.42 |
| Total Medical Medicare Payment Amount | 131700.73 |
| Total Medical Medicare Standardized Payment Amount | 131283.93 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 203 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 349 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 142 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2331 |