National Provider Identifier [NPI]: |
1285628982 |
Last Name Of The Provider |
JAFFE |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
35 TOWER CT |
Street Address 2 Of The Provider |
STE F |
City Of The Provider |
GURNEE |
Zip Code Of The Provider |
600315712 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
7169 |
Number Of Medicare Beneficiaries |
2301 |
Total Submitted Charge Amount |
1238835 |
Total Medicare Allowed Amount |
657490.39 |
Total Medicare Payment Amount |
495080.11 |
Total Medicare Standardized Payment Amount |
473223.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
455 |
Number Of Medicare Beneficiaries With Drug Services |
113 |
Total Drug Submitted ChargeAmount |
45500 |
Total Drug Medicare AllowedAmount |
23330.55 |
Total Drug Medicare PaymentAmount |
17845.46 |
Total Drug Medicare Standardized Payment Amount |
17845.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
61 |
Number Of Medical Services |
6714 |
Number Of Medicare Beneficiaries With Medical Services |
2301 |
Total Medical Submitted Charge Amount |
1193335 |
Total Medical Medicare Allowed Amount |
634159.84 |
Total Medical Medicare Payment Amount |
477234.65 |
Total Medical Medicare Standardized Payment Amount |
455378.1 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
254 |
Number Of Beneficiaries Age 65 to 74 |
740 |
Number Of Beneficiaries Age 75 to 84 |
809 |
Number Of Beneficiaries Age Greater 84 |
498 |
Number Of Female Beneficiaries |
1237 |
Number Of Male Beneficiaries |
1064 |
Number Of Non Hispanic White Beneficiaries |
1853 |
Number Of Black or African American Beneficiaries |
226 |
Number Of AsianPacific Islander Beneficiaries |
40 |
Number Of Hispanic Beneficiaries |
153 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1782 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
519 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9169 |