National Provider Identifier [NPI]: |
1831152370 |
Last Name Of The Provider |
KERR |
First Name Of The Provider |
JEFFERY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11851 ARBOUR CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROLLA |
Zip Code Of The Provider |
654017476 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
2906 |
Number Of Medicare Beneficiaries |
1319 |
Total Submitted Charge Amount |
650498 |
Total Medicare Allowed Amount |
290687.81 |
Total Medicare Payment Amount |
210011.56 |
Total Medicare Standardized Payment Amount |
220903.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
2906 |
Number Of Medicare Beneficiaries With Medical Services |
1319 |
Total Medical Submitted Charge Amount |
650498 |
Total Medical Medicare Allowed Amount |
290687.81 |
Total Medical Medicare Payment Amount |
210011.56 |
Total Medical Medicare Standardized Payment Amount |
220903.86 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
251 |
Number Of Beneficiaries Age 65 to 74 |
278 |
Number Of Beneficiaries Age 75 to 84 |
384 |
Number Of Beneficiaries Age Greater 84 |
406 |
Number Of Female Beneficiaries |
863 |
Number Of Male Beneficiaries |
456 |
Number Of Non Hispanic White Beneficiaries |
1290 |
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 |
770 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
549 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6082 |