National Provider Identifier [NPI]: |
1679517585 |
Last Name Of The Provider |
FLETCHER |
First Name Of The Provider |
JEFFERSON |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
970 LAKELAND DR |
Street Address 2 Of The Provider |
SUITE 61 |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164635 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
16584 |
Number Of Medicare Beneficiaries |
4236 |
Total Submitted Charge Amount |
1740810 |
Total Medicare Allowed Amount |
487252.95 |
Total Medicare Payment Amount |
357035.32 |
Total Medicare Standardized Payment Amount |
381129.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
6053 |
Number Of Medicare Beneficiaries With Drug Services |
138 |
Total Drug Submitted ChargeAmount |
25475 |
Total Drug Medicare AllowedAmount |
16838.94 |
Total Drug Medicare PaymentAmount |
12837.17 |
Total Drug Medicare Standardized Payment Amount |
12837.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
10531 |
Number Of Medicare Beneficiaries With Medical Services |
4236 |
Total Medical Submitted Charge Amount |
1715335 |
Total Medical Medicare Allowed Amount |
470414.01 |
Total Medical Medicare Payment Amount |
344198.15 |
Total Medical Medicare Standardized Payment Amount |
368292.14 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
712 |
Number Of Beneficiaries Age 65 to 74 |
1544 |
Number Of Beneficiaries Age 75 to 84 |
1346 |
Number Of Beneficiaries Age Greater 84 |
634 |
Number Of Female Beneficiaries |
2336 |
Number Of Male Beneficiaries |
1900 |
Number Of Non Hispanic White Beneficiaries |
3068 |
Number Of Black or African American Beneficiaries |
1118 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
21 |
Number Of Beneficiaries With Medicare Only Entitlement |
3153 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1083 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.6055 |