National Provider Identifier [NPI]: |
1952399966 |
Last Name Of The Provider |
MILES |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3725 W 4100 S |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST VALLEY CITY |
Zip Code Of The Provider |
841205530 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
465 |
Number Of Medicare Beneficiaries |
184 |
Total Submitted Charge Amount |
51634 |
Total Medicare Allowed Amount |
24981.94 |
Total Medicare Payment Amount |
15432.56 |
Total Medicare Standardized Payment Amount |
17009.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
16 |
Total Drug Submitted ChargeAmount |
482 |
Total Drug Medicare AllowedAmount |
225.45 |
Total Drug Medicare PaymentAmount |
207.41 |
Total Drug Medicare Standardized Payment Amount |
207.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
440 |
Number Of Medicare Beneficiaries With Medical Services |
184 |
Total Medical Submitted Charge Amount |
51152 |
Total Medical Medicare Allowed Amount |
24756.49 |
Total Medical Medicare Payment Amount |
15225.15 |
Total Medical Medicare Standardized Payment Amount |
16802.06 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
116 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
148 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
155 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
27 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9788 |